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PHỤ LỤC 1
ĐÁNH GIÁ MỨC ĐỘ XƠ HÓA GAN BẰNG SINH THIẾT GAN VÀ CÁC BIỆN PHÁP KHÔNG XÂM NHẬP
(Ban hành kèm theo Quyết định số /QĐ-BYT ngày tháng năm 2016 của Bộ trưởng Bộ Y tế)
APRI
APRI =
AST của bệnh nhân x 100
/AST giới hạn trên mức bình thường theo phòng XN
Tiểu cầu (G/L) APRI < 0,5 : F0-F1
APRI 0,5 - 1,0 : F2 APRI 1,0 - 2 : F3
FIB-4 (Fibrosis -4)
FlB-4 =
Tuổi (năm) x ALT (U/L) Tiểu cầu
(G/L)x FIB-4: < 1,45 : F0-F1
FlB-4: 1,45 - 3,25 : đánh giá thêm bằng Fibroscan FIB > 3,25 : F2-F4
Phân loại xơ gan theo Child-Pugh
Nội dung Điểm số
1 2 3
Bilirubin toàn phần
mg/dL (mmol/L) < 2 (< 34) 2-3 (34-50) > 3 (> 50) Albumin huyết thanh
g/L (mmol/L) > 35 (> 507) 28-35 (406-507) < 28 (< 406) INR hoặc Thời gian
Prothrombine (giây: s)
< 1,7 1,71-2,30 > 2,30
< 4 4-6 > 6
Cổ trướng Không Nhẹ/trung bình (đáp
ứng với lợi tiểu)
Nặng (Không đáp ứng với thuốc lợi
tiểu) Hội chứng não gan Không
Mức độ I-II (hoặc có thể kiểm soát với
thuốc)
Mức độ III-IV (hoặc không phục
hồi) Phân loại: Mức độ A: 5-6 điểm, mức độ B: 7-9 điểm; mức độ C: 10-15 điểm Xơ gan mất bù: Child Pugh B hoặc C