摘要
目的探讨血清腹水白蛋白梯度在鉴别腹水性质中的临床价值。方法连续收集诊断明确的腹水患者161例,同日测定血清腹水白蛋白梯度(SAAG)、腹水总蛋白(AF-TP),评价AFTP和SAAG两种分类方法对腹水性质诊断的准确率、敏感度、特异度、阳性预测值、阴性预测值。通过受试者工作特征曲线(ROC)评价SAAG≥11g/L判断门脉高压的准确性和AFTP≥25g/L判断渗出液的准确性。结果以SAAG≥11g/L诊断门脉高压性腹水的准确率为94.41%,约登指数为0.87;AFTP≥25g/L诊断渗出液的准确率为81.37%,约登指数为0.6552。SAAG≥11g/L预测门脉高压和AFTP≥25g/L预测渗出液的ROC曲线下面积分别为0.987和0.844。结论将腹水依据SAAG判定为门脉高压性和非门脉高压性腹水更有助于腹水鉴别诊断。
Objective To explore the utility of serum-ascites albumin gradient with the exudate-transudate concept in the classification of ascite.Methods Collection of ascitic fliuid date from one hundred and sixty one patients with an identifiable cause of ascites.Serum and ascitic fluid were obtained on the same day,serum-ascites albumin gradient（SAAG）and ascitic fluid total protein（AFTP）were measured.Evaluated with diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of the serum ascites albumin gradient,and AFTP for the separation of ascites into transudate and exudate.Using receiver operating characteristic curve（ROC）assessed the accuracy of a SAAG of at least 11 g/L in detecting portal hypertension and of an AFTP of at least 25 g/L in detecting exudate.Results The accuracy and Youden＇s index of SAAG≥11 g/L diagnose portal hypertension were 94.41% and 0.87 respectively.In contrast,the accuracy and Youden＇s index of AFTP≥25 g/L in the diagnosis exudates were 81.37% and 0.6552 respectively.The area under the ROC curve of SAAG≥11 g/L prediction of portal hypertension and AFTP≥25 g/L prediction of exudate were 0.987 and 0.844.Conclusion There are significant clinical value for SAAG,which identify ascites fluid of portal hypertension from nonportal hypertension,it is contribute to the differential diagnosis of ascites.
出处
《安徽医科大学学报》
CAS
北大核心
2010年第1期69-72,共4页
Acta Universitatis Medicinalis Anhui
