Abstract: Objective To explore the dynamic changes of human neutrophil lipocalin (HNL) and cytokines (TNF-α,IL-6, IL-1β) in patients with liver failure undergoing double plasma molecular adsorption system (DPMAS)artificial liver therapy, as well as their value in evaluating treatment efficacy. Methods A total of 167 patients with liver failure admitted to the Department of Infectious Diseases at the First Affiliated Hospital of Nanchang University from January 2023 to December 2024 were selected. They were divided into an effective group (n=132) and an ineffective group (n=35) according to the therapeutic effect 4 weeks after treatment. The levels of HNL, TNF-α,IL-6, and IL-1β were detected in both groups before treatment and at 1 week, 2 weeks, and 4 weeks after treatment. Meanwhile, alanine transaminase (ALT), total bilirubin (TBIL), albumin (ALB), prothrombin activity (PTA), and international normalized ratio (INR) were measured synchronously. The correlation between HNL, cytokines and liver function indicators was analyzed, and the predictive value of HNL and cytokines for the efficacy of DPMAS was evaluated. Results In the effective group, the levels of HNL, IL-6, TNF-α, IL-1β, ALT, TBIL, and INR at 1 week, 2 weeks, and 4 weeks after treatment were significantly lower than those before treatment and in the ineffective group at the same period, while ALB and PTA were significantly higher than those before treatment and in the ineffective group at the same period (P＜0.05). HNL and cytokines were positively correlated with ALT, TBIL, and INR, and negatively correlated with ALB and PTA (P＜0.05). The AUC of HNL combined with cytokines in predicting the efficacy of DPMAS was 0.956, which was significantly higher than that of each index alone(P＜0.05). Conclusions HNL and cytokines can dynamically reflect the therapeutic effect of DPMAS, and their combined detection has important clinical value in evaluating the efficacy of liver failure treatment.

Key words: human neutrophil lipocalin, cytokines, liver failure, double plasma molecular adsorption system