Massive cellular necrosis in acute liver failure (ALF) is dominantly immune mediated and innate immune cells are major pathophysiological determinants in liver damage.

In fifty ALF and fifteen healthy, immune cells phenotyping by flow-cytometry, DAMPs using ELISA were analysed and correlated with clinical and biochemical parameters.

ALF patients (aged 27 ± 9 yr, 56% males, 78% viral aetiology) showed no difference in neutrophils and classical monocytes, but significantly increased intermediate monocytes (CD14⁺CD16⁺) (p < 0.01), decreased non-classical monocytes (CD14⁻CD16⁺) and CD3^-veCD16⁺CD56⁺ NK cells compared to HC. ALF patients who survived, showed higher NK cells (9.28 vs. 5.1%, p < 0.001) among lymphocytes and lower serum lactate levels (6.1 vs. 28, Odds ratio 2.23, CI 1.27–3.94) than non- survivors had higher. Logistic regression model predicted the combination of lactate levels with NK cell percentage at admission for survival.

In conclusion, Combination of NK cell frequency among lymphocytes and lactate levels at admission can reliably predict survival of ALF patients.

急性肝衰竭 (ALF) 中的大量细胞坏死主要是免疫介导的，先天免疫细胞是肝损伤的主要病理生理决定因素。

在通过流式细胞术对 50 个 ALF 和 15 个健康免疫细胞进行表型分析时，使用 ELISA 分析了 DAMP，并将其与临床和生化参数相关联。

ALF 患者（27 ± 9 岁，56% 男性，78% 病毒病因）中性粒细胞和经典单核细胞没有差异，但中间单核细胞（CD14 ⁺ CD16 ⁺）显着增加（p  < 0.01），非经典单核细胞减少（ CD14 ^- CD16 ⁺ ) 和 CD3 ^-ve CD16 ⁺ CD56 ⁺ NK 细胞与 HC 相比。幸存的 ALF 患者显示出更高的 NK 细胞（9.28 对 5.1%，p < 0.001）和较低的血清乳酸水平（6.1 对 28，优势比 2.23，CI 1.27-3.94）比非幸存者更高。Logistic 回归模型预测了入院时乳酸水平与 NK 细胞百分比的组合以维持生存。

总之，淋巴细胞中 NK 细胞频率和入院时乳酸水平的组合可以可靠地预测 ALF 患者的存活率。