How is the severity of chronic hepatitis B cirrhosis determined?

  Cirrhosis is the result of the development of chronic hepatitis B. Once the disease reaches the stage of cirrhosis, it is marked by diffuse fibrosis and nodule formation in the liver tissue. The severity of cirrhosis is mainly determined by the patient’s symptoms, signs, liver function laboratory indicators and relevant special tests such as ultrasound.  (1) Mild cirrhosis: ① Asymptomatic cirrhosis. No clear history of liver disease, no obvious symptoms of liver disease, or had a history of hepatitis B virus carriage, the body has been quite good, and was found during the physical examination. ②Compensated cirrhosis. It refers to early cirrhosis, which is seen as mild weakness, reduced appetite or abdominal distension symptoms, but no obvious manifestation of liver failure. Serum albumin is reduced but still greater than or equal to 35g/L, bilirubin is less than or equal to 35μmol/L, prothrombin activity is more than 60%, glutathione and glutamic oxalacetic aminotransferase are mildly elevated, and transpeptidase may be mildly elevated. There may be portal hypertension, such as mild esophageal varices, but no ascites, hepatic encephalopathy or upper gastrointestinal bleeding. (iii) Quiescent cirrhosis. Normal ghrelin, no obvious jaundice , hard liver, large spleen with portal hypertension and low serum albumin level.  (2) More severe cirrhosis: ①Decompensated cirrhosis. It refers to intermediate and advanced cirrhosis with obvious abnormal liver function and signs of decompensation, such as serum albumin less than 35 g/L, albumin to globulin ratio less than 1.0, obvious jaundice, bilirubin greater than 35 μmol/L, elevated glutamic aminotransferase and glutamic oxalacetic aminotransferase, and coagulation perigen activity less than 60%. Patients may develop ascites, hepatic encephalopathy main portal hypertension caused by significant esophageal and fundic venous varices or ruptured bleeding. ②Active cirrhosis. The clinical manifestations of chronic hepatitis remain, and the appearance of deeper jaundice is the hallmark of this type of cirrhosis. Aminotransferases are elevated in the early stage and gradually decrease in the later stage; while jaundice gradually rises and forms a separation phenomenon; albumin level decreases, liver texture becomes hard, spleen progressively enlarges and is accompanied by portal hypertension.