肝硬化患者血清腹水清蛋白梯度与肝性脑病的关系

Correlation between SAAG and hepatic encephalopathy in patients with liver cirrhosis

目的探讨肝硬化失代偿期患者血清腹水清蛋白梯度(SAAG)与肝性脑病的关系。方法 120例肝硬化失代偿期腹水并发肝性脑病患者,其中,Ⅰ级肝性脑病(A组)41例;Ⅱ级肝性脑病(B组)43例;Ⅲ～Ⅳ级肝性脑病(C组)36例。在腹腔穿刺抽液的当日早晨空腹采血测定血清总蛋白、清蛋白;腹水总蛋白、清蛋白。SAAG=血清清蛋清-腹水清蛋白。如果血清球蛋白<30g/L或>50g/L,用公式校正SAAG。结果 120例血清腹水清蛋白梯度(SAAG)均≥11g/L,符合门脉高压性腹水。A组SAAG为(12.70±0.45)g/L;B组SAAG为(16.62±1.70)g/L;C组SAAG为(22.96±2.46)g/L。B组与A组比较P<0.01;C组与B组比较P<0.01;C组与A组比较P<0.01,差异有统计学意义。结论血清腹水清蛋白梯度对判断肝性脑病的程度及预后具有临床价值。

Objective To observe correlation between serum-ascites albumin gradient （SAAG） and hepatic encephalopathy in patients with decompensated liver cirrhosis. Methods One hundred and twenty cases of decompensated liver cirrhosis patients with ascites and hepatic encephalopathy were studied, which included gradeⅠhepatic encephalopathy （group A） in 41 cases, grade Ⅱ hepatic encephalopathy （group B） in 43 cases and Ⅲ- Ⅳ grade of hepatic encephalopathy （Group C） in 36 cases. Fasting blood was collected to determine total protein and albumin of serum on the morning when doing abdominal paracentesis. Ascitic was collected to determine total protein and albumin. SAAG=serum albumin-ascitic albumin. If the serum globulin 30 g/L or 50 g/L, we used the formula calibrating SAAG. Results SAAG of 120 cases≥ 11 g/L, which complied with portal hypertension ascites. The SAAG of group A, B, C was （12.70±0.45） g/L, （16.62±1.70） g/L and （22.96±2.46） g/L respectively. There was statistical difference between group B and A （P 0.01）, C and B （P 0.01） and C and A （P 0.01）. Conclusion It is clinically valuable for SAAG to determine the degree and prognosis of hepatic encephalopathy.