血清-腹水白蛋白梯度与食管静脉曲张破裂出血的关系

Subject relationship between serum ascites albumin gradient and esophageal variceal bleeding

目的探讨血清-腹水白蛋白梯度(Serum-ascites albumin gradient,SAAG)与门脉高压性食管静脉曲张破裂出血的关系,评价SAAG对预测门脉高压性食管静脉曲张破裂出血的价值。方法测定47例肝硬化腹水患者SAAG值并行胃镜检查以了解有无食管静脉曲张,以11g/L为界将47例患者分为高SAAG组及低SAAG组,分析SAAG与食管静脉曲张之间的关系。47例患者中并发食管静脉曲张破裂出血者15例,非出血者32例,测定两组患者的SAAG值并进行比较。结果 SAAG与食管静脉曲张、出血存在正相关关系(r=0.523,P<0.01;r=0.466,P<0.01);15例出血组患者其SAAG值为(22.67±4.47)g/L,32例非出血组患者其SAAG值为(17.25±5.21)g/L,两组比较差异有显著性(P<0.05)。结论 SAAG与门脉压力密切相关且对预测门脉高压性食管静脉出血有重要临床价值。

Objective To study the relationship between serum-asicites albumin gradient（ SAAG） and the portalhypertensive ascites in order to appreciate the value of SAAG on the prediction of esophageal-gastric fundus variceal bleeding. Methods 47patients with cirrhotic ascites were examined with endoscopy. The patients were classified as high-gradient group and low-gradient group by the SAAGvalue of 11 g/L. The relationship between SAAG and esophagel-gastric fundus variceswas studied by Pear-son correlation analysis. Among the 47 patients studied,15 patients had esophageal-gastric fundus varicealbleeding and 32 patients had no esophageal-gastric fundus variceal bleeding. Results The result showed the directcorrelation between the level of SAAG and the degree of esophageal-gastric fundus variceas（ r = 0. 523,P〈0. 01; r = 0. 466,P〈0. 01） . Themean level of SAAG in bleeding group,consisting 15patients,was（ 22. 67 ± 4. 47） g/L. Themean level of SAAG in nonbleeding group,consisting 32 patients,was（ 17. 25 ± 5. 21） g/L. The result showed a significantly difference between the bleeding group and non-bleeding group（ P〈0. 05） . Conclusion There is correlation between the level of SAAG and the portalvenous pressure. The level of SAAG is valueable on the prediction of esophagealgastric fundus variceal bleeding.