血清-腹水白蛋白梯度对门脉高压的诊断价值

目的:探讨血清-腹水白蛋白梯度(SAAG)对门脉高压的诊断价值。方法:选择腹水患者68例,其中肝硬化(A组)21例,原发性肝癌无腹膜转移(B组)10例,在失代偿肝硬化基础上并发自发性细菌性腹膜炎(C组)5例,结核性腹膜炎(D组)20例,癌性腹水(E组)12例。于治疗前腹腔穿刺取腹水及抽取肘静脉血,检测白蛋白浓度,并计算SAAG。结果:A、B、C三组SAAG均显著高于D组和E组SAAG。合并A、B、C三组为门脉高压组,合并D、E组为非门脉高压组,门脉高压组SAAG显著高于非门脉高压组SAAG。以SAAG≥11.0 g/L为界,SAAG对门脉高压诊断的敏感度94.4%(34/36),特异度为96.9%(31/32),准确度为95.6%(65/68)。结论:SAAG对门脉高压性腹水具有重要诊断价值,值得临床应用推广。

Value of Serum-Ascites-Albumin Gradient (SAAG) in Diagnosis of Portal Hypertension

Objective： To investigate the value of serum-ascites-albumin gradient （SAAG） in diagnosis of portal hypertension. Method：Sixty-eight cases of ascites patients were selected, among which 21 cases were suffering from cirrhosis of liver （group A）, 10 contracted primary liver cancer without peritonaeum metastasis （group B）, 5 cases were the patients with dysfunctional cirrhosis of liver complicated with spontaneous bacterial peritonitis （group C）, 20 were sick with tuberculous peritonitis （group D）, and 12 were cancer patients induced ascites （group E）. Before treatment, ascites and elbow vein blood were collected by abdominocentesis and venipuncture respectively. Albumin concentration was examined, and SAAG was calculated. Result. SAAG of group A , B and C were higher than that of groups D and E respectively. Group A, B, C were combined as the portal hypertension group, and groups D, E as the non-portal hypertension group. The boundary of SAAG was set ≥11.0g/L. The sensitivity of the former was 94. 4% （34/36）, distinctive degree was 96. 9% （31/32）, and the accurate degree was 95. 6~ （65/68）. Conclusion.. SAAG is of great medical significance in diagnosis of portal hypertension and worthy for clinical application.