血清-腹水白蛋白梯度在腹水病因鉴别诊断中的价值

Value of Serum Ascitic Albumin Gradient in Differential Diagnosis of Ascitic Etiologies

目的探讨SAAG和其他实验室指标在腹水病因鉴别诊断中的价值。方法回顾性分析以腹水待查入院的53例患者的病史,按出院诊断分为门静脉高压相关疾病组(30例)和非门静脉高压相关疾病组(23例);以同一天测定的血清白蛋白浓度和腹水白蛋白浓度计算SAAG,比较两组SAAG与诊断的关系。结果门静脉高压相关组的SAAG(18.27g/L±2.05g/L)显著高于非门静脉高压相关组(6.72g/L±1.38g/L)(P<0.001)。以SAAG≥11g/L为界限值,诊断门静脉高压相关性腹水的敏感性为96.67%,特异性为91.30%,准确性为94.34%。结论SAAG鉴别法的鉴别符合率明显高于传统腹水鉴别法,但不能取代腹水有核细胞计数和细胞学等检查,联合检测能有效提高腹水原因诊断准确率。

Objective To evaluate the diagnostic value and reliability of SAAG and other laboratory tests in patients with ascites. Methods Case records of 53 patients with ascites were reviewed retrospectively.The patients were divided into 2 groups,the groups associated with portal hypertension（30 patients） and the group without portal hypertension（23 patients）. The SAAG were calculated using the serum and ascitic albumin levels on the same day. Results The mean level and standard deviation of SAAG of the group associated with portal hypertension and the group without portal hypertension was （18.27 ± 2.05 ）g/L, and （6.72 ± 1.38）g/L, respectively （P 〈 0.001 ）. Using SAAG ≥ 11g/L as the cut-off value, the diagnostic sensitivity for ascites associated with portal hypertension was 96.67%, diagnostic specificity was 91.30%, diagnostic accuracy 94.34%. Conclusion The coincidence rate of SAAG differentiation method is evidently higher than the traditional ascites differentiation methods, but it can＇t instead of the detection of ascitic haryotes number and cytological detection. Therefore, the associated detection of the two methods would effectively increase the accurate rate of the diagnosis of the couse of ascities.