Some clinical manifestations of compensated cirrhosis

  Early symptoms of cirrhosis are usually insidious and easily overlooked in patients without a history of liver disease, and many cases are found to have cirrhosis when a physical examination is performed. Depending on the severity of the disease, it is often divided into compensated cirrhosis and decompensated cirrhosis. The compensated cirrhosis is relatively mild compared with the decompensated stage, and the course of the disease develops slowly, usually after 3-5 years of untreated cirrhosis can evolve into decompensated cirrhosis. Most of the compensated cirrhosis can stop developing and stabilize for a long time with proper treatment and life conditioning.  The clinical symptoms of compensated cirrhosis lack specificity. A small number of people may have no conscious symptoms, most of them appear early with weakness and loss of appetite, which may be accompanied by abdominal distension and discomfort, nausea, vague pain in the upper abdomen and mild diarrhea. Some patients may have non-specific gastrointestinal symptoms such as vomiting, dry mouth, bitter mouth, nausea, aversion to oil, warmth, etc. The above symptoms may be mild or severe. They are triggered by exertion or concomitant other diseases and can be relieved after proper rest or treatment. Physical examination may reveal a hard texture of the liver or an enlarged spleen, and imaging examinations such as ultrasound and CT may provide a reference basis for diagnosis. Liver function tests are mildly abnormal or basically normal, and some patients have decreased albumin and increased globulin. Patients with long-term stable cirrhosis in the compensated stage are almost always negative for HBV-DNA, and those who are still in the progressive stage are positive for the attached HBV-DNA. Compensated cirrhosis becomes blood Rt can play thrombocytopenia, neutropenia and other phenomena.  Compensated cirrhosis is not easily distinguished from chronic hepatitis, especially the differential diagnosis of chronic active hepatitis is very difficult, the latter mostly exists higher serum enzymatic changes, palpation of the liver texture is medium, ultrasound has auxiliary differential diagnostic significance. In compensated cirrhosis, the patient has signs of cirrhosis, ultrasound shows dilated portal vein or shrunken liver with unsmooth surface or jagged changes, serum test may have AST/ALT >2, A/G <1, or splenomegaly, small amount of ascites, etc. However, some patients in quiescent stage have normal liver function in serum test, and the general condition is still acceptable. The differential diagnosis of cirrhosis also includes the diagnosis of the etiology of cirrhosis, such as alcoholic cirrhosis, biliary cirrhosis, drug-related cirrhosis, cardiogenic cirrhosis, etc.