摘要
目的将血清腹水白蛋白梯度(SAAG)与渗漏出液分类方法进行比较,认识其在腹水鉴别诊断中的价值。方法选择腹水患者123例,将其按腹水发生机制是否与门静脉高压相关及渗漏出液概念2种方法进行分类,同日测定SAAG、腹水总蛋白(AFTP)、腹水总蛋白/血清总蛋白比值(A/S)、腹水乳酸脱氢酶(LDH)。判断标准为:AFTP≥25 g/L、A/S≥0.5、LDH≥200U/L腹水为渗出性,AFTP<25 g/L、A/S<0.5、LDH<200 U/L为漏出性;SAAG≥11 g/L腹水为门静脉高压性,SAAG<11g/L为非门静脉高压性。结果门静脉高压组SAAG值为(19.32±4.39)g/L,非门静脉高压组SAAG值为(7.11±2.73)g/L,2组比较差异有统计学意义(F=196.4,P<0.01)。SAAG对门静脉高压诊断的准确性为94.31%,AFTP、A/S、LDH诊断的准确性分别为62.60%、67.48%和75.61%,均明显低于SAAG。结论SAAG对鉴别门静脉高压性和非门静脉高压性腹水具有重要的临床价值,是一种较传统的渗漏出液概念更准确的分类方法。
Objective To compare the utility of serum-ascites albumin gradient （SAAG） with the exudate-transudate concept in the classification of ascite. Methods One hundred and twenty three patients with ascites were enrolled into our study. Serum and ascitic fluid were obtained on the same day. SAAG, ascitic fluid total protein（AFTP）, ascites/serum total protein ratio（A/S） and ascitic fluid LDH were measured. SAAG was defined as the serum albumin concentration minus the ascitic fluid albumin concentration, and it was classified into high-gradient（SAAG≥ 11 g/L） and low-gradient （SAAG〈 11 g/L）. AFTP≥ 25 g/L, A/S≥0.5, LDH≥200 U/L were diagnosised as exudates fluid. Results The mean SAAG in patients with diseases associated with portal hypertension was significantly higher than that in patients with diseases not associated with portal hypertension [（19.32±4. 39）g/L vs （7. 11±2. 73） g/L, P〈0.01], giving a significantly higher diagnostic sensitivity, specificity and accuracy （95. 69%, 90. 00% and 94. 31%, respectively） than that of exudate-transudate classification （62. 60%, 67.48% and 75. 61%, respectively）. Conclusion SAAG is valuable to differentiate ascitic fluid of portal hypertension from that of non-portal hypertension, and is superior to the exudate - transudate classification.
出处
《首都医科大学学报》
CAS
2006年第4期460-463,共4页
Journal of Capital Medical University
关键词
血清腹水白蛋白梯度
门静脉高压
腹水
serum-ascites albumin gradient
portal hypertension
ascites
