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mDF 計算機 (modified Discriminant Function)

Maddrey’s Discriminant Function
用於預測酒精性肝炎(Alcoholic hepatitis)患者嚴重程度及短期預後的計算機。
mDF = 4.6 x (PT[patient](s) – PT[control](s)) + Total bilirubin (mg/dL)








mDF < 32 : 中度酒精性肝炎(Moderate alcoholic hepatitis)
mDF ≥ 32 : 重度酒精性肝炎(Severe alcoholic hepatitis)

Reference :
Maddrey WC, Boitnott JK, Bedine MS, Weber FL Jr, Mezey E, White RI Jr. Corticosteroid therapy of alcoholic hepatitis. Gastroenterology. 1978 Aug;75(2):193-9. PMID: 352788.

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EASL Clinical Practice Guidelines: Management of alcohol-related liver disease (2018)
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In patients with a clinical diagnosis of alcoholic hepatitis, confounding factors (see text) need to be ruled out, if necessary, by transjugular (TJ) liver biopsy. Patients with severe alcoholic hepatitis (AH), defined as Maddrey discriminant function (MDF) ≥32 or Model for End-Stage Liver Disease (MELD) score >20, without contraindications for glucocorticoids (see text) are candidates for such treatment. Nonresponders or patients with contraindications for treatment should be considered for early liver transplantation (LT) or supportive or palliative care, as clinically appropriate. (Harrison’s Principles of Internal Medicine 21st Edition)
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EASL Clinical Practice Guidelines: Management of alcohol-related liver disease (2018)