血清-腹水白蛋白梯度、腹水/血清总胆红素比值联合检测对腹水性质的鉴别诊断价值

Value of combined detection of serum-ascites albumin gradient and ascitic/serum total bilirubin ratio in the differential diagnosis of ascites

目的:探讨血清-腹水白蛋白梯度(SAAG)、腹水/血清C-反应蛋白(CRP)、腹水/血清总胆红素(TBil)三种指标在不同性质腹水鉴别诊断中的价值。方法:收集2017至2018年在佛山市第二人民医院行腹腔穿刺术患者145例的血清和腹水样本,并将样本分为2组,即漏出液组57例,渗出液组88例。同步测定血清-腹水白蛋白梯度、腹水/血清CRP、腹水/血清总胆红素,并将结果进行比较分析。结果:与漏出液组相比,渗出液组SAAG低于漏出液组,而渗出液组腹水/血清TBil比值高于漏出液组(P<0.05)。受试者工作特征曲线(ROC)分析显示,SAAG区分漏出液和渗出液的曲线下面积(AUC)为0.678,腹水/血清TBil区分漏出液和渗出液的AUC为0.703。两者联合的AUC为0.709。结论:血清-腹水白蛋白梯度、腹水/血清总胆红素比值可以作为鉴别腹水性质的可靠指标。

Objective: To investigate the diagnostic value of combined serum ascites albumin gradient(SAAG), ascitic/serum CRP ratio, and ascitic/serum total bilirubin(TBil)ratio in ascites.Methods:A total of 145 ascites cases were collected in Foshan Second People′s Hospital from 2017 to 2018, including 57 patents in transudative group and 88 patients in exudative group. SAAG, ascitic/serum CRP ratio, and ascitic/serum TBil ratio were detected.Results: Compared with that respectively in transudative ascites group, the level of SAAG level in exudative ascites group were higher, while the level of ascitic/serum TBil ratio were lower. ROC analysis showed that the area under the curve(AUC) of SAAG and ascites/serum TBil ratio to differentiate and transudative ascites was 0. 678 and703, respectively. The combination of them reached a AUC of 0. 709.Conclusion: SAAG and ascitic/serum TBil ratio can be a reliable biomarker in the differential diagnosis of ascites.