How is cirrhosis clinically graded?

  Decompensated cirrhosis and compensated cirrhosis are only rough clinical estimates of liver storage function in patients with cirrhosis, and there is no clear boundary between the two stages; moreover, the clinical severity of patients with decompensated cirrhosis still varies greatly. Therefore, some scholars have stratified and scored important clinical indicators and laboratory tests in patients with cirrhosis to facilitate clinical judgment of the severity of the patients’ disease. For example, Child’s liver function grading method, which is based on three clinical indicators (ascites, neuropsychiatric symptoms and nutritional status) and two liver function indicators (serum bilirubin and clear protein) of cirrhotic patients, was classified into A, B and C levels according to the degree of liver function impairment by Child in 1964, and was a classical grading method widely used in clinical practice. In 1973, PUgh created the Child-Pugh modified scoring method on the basis of the Child grading method by removing the item of nutritional status and adding the item of prolongation of prothrombin time, and adopted the scoring method, which made it easier to grasp in clinical practice. It is more accurate in determining the degree of liver function damage and prognosis. However, the etiology of liver cirrhosis in Western countries is mainly alcoholic cirrhosis. These data are derived from the group of mainly alcoholic cirrhosis, while for the group of mainly chronic viral hepatitis cirrhosis in China, the incidence of bilirubin and prothrombin time abnormalities is low, in accordance with the principle of choosing the fewest indicators to reflect the prognosis to the greatest extent possible and the simplicity and ease of analysis. The principle of objectivity and practicality, Qian Xuelin et al. screened out a new grading method with only 2 indicators from it (various liver function grading methods are attached), namely, clear protein, ascites and encephalopathy, and used the scoring method to classify liver function into 4 grades, and concluded that the new method was more objective and accurate for patient prognosis.