血清-腹水白蛋白梯度在腹水病因鉴别中的意义

Value of Serum Albumin Gradient in Differential Diagnosis of Ascitic Etiologies

目的:探讨血清-腹水白蛋白梯度(SAAG)在腹水病因鉴别中的应用价值。方法:回顾性分析以腹水原因待查入院的68名患者的病例,按出院诊断分为门静脉高压相关疾病组38例和非门静脉高压相关疾病组30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:门静脉高压相关疾病组的SAAG(18.25±2.03)g/L显著高于非门静脉高压相关疾病组(6.84±1.39)g/L(P<0.01)。以SAAG≥11 g/L为界限值,诊断门静脉高压相关性腹水的敏感性为94.21%,特异性为96.67%,准确性为95.59%。结论:SAAG鉴别法的鉴别符合率明显高于传统腹水鉴别法,但不能取代腹水细胞学等检查。联合检测,综合分析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 examinations in patients with ascites.Methods：Sixty-eight patients with ascites were reviewed retrospectively.The patients were divided into 2 groups,the group associated with portal hypertension（38 patients）and the group without portal hypertension（30 patients）.SAAG was calculated using the serum and ascetic 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（18.25±2.03）g/L and（6.84±1.39）g/L（P〈0.01）.Using SAAG≥11 g/L as the cutoff value,the diagnostic sensitivity for ascites associated with portal hypertension was 94.21%,diagnostic specificity was 96.67%,diagnostic accuracy was 95.59%.Conclusion： The coincidence rate of SAAG differentiation method is evidently higher than traditional ascites differentiation methods,but it can＇t instead of the detection of ascetic haryote＇s number and cytological detection.Therefore,the associated detection of the two methods would effectively increase the accurate rate of the diagnosis of the cause of ascities.