血清—腹水白蛋白梯度与渗漏出液在腹水鉴别诊断中的价值比较

目的：比较血清－腹水白蛋白梯度（SAAG）在不同病因腹水中的差异，了解其在腹水诊断方面的优越性。方法：同日内测定84例腹水患的血清与腹水中总蛋白和白蛋白的值，并测定腹水比重及乳酸脱氢酶。结果；门脉高压组患血清－腹水白蛋白梯度，腹水总蛋白，腹水白蛋白，腹水血清总蛋白比值，腹水比重，腹水LDH等六项指标与非门脉高压组患比较均有高度显性差异。而血清腹水白蛋白梯度的诊断门脉高压性腹水的敏感度为95．56％，特异性为97．44％，准确率为96．43％，阳性似然比为37．73，阴性似然比为0．9807，均显高于诊断渗漏出液分类方法的各项指标。结论：血清－腹水白蛋白梯度对鉴别门脉高压性和非门脉高压性腹水具有重要的临床价值，可推广应用。

Comparison of value of serum-ascites albumin gradient with exudates and transudates in the diagnosis of ascites

Objective:To compare the differences of SAAG in different cases of ascites,and evaluate the advantages of SAAG in the diagnosis of ascites Methods:Total albumen and albumin in serum and ascites of 84 cases were determined within one day,the specific gravity and lactic acid dehydrogenase(LDH) of ascites were determined respectively Results:There were significant differences in SAAG,total ascites albumen,ascites albumin,the ratio of total ascites albumen to total serum albumen,the specific gravity of ascites and LDH of ascites between portal hypertension group and non portal hypertension group.In the diagnosis of portal hypertensive ascites that used SAAG,the sensitivity ratio was 95 56%,the specificity was 97 44%,the accurat rate was 96 43%,the positive likelihood ratio was 37 72 and the negative likelihood ratio was 0 9807.All these indexes were significant higher than that in the diagnosis that used exudates and transudates Conclusion:SAAG is of great clinical significance in the diagnosis of portal hypertensive ascites and non portal hypertensive ascites,it is worth to popularize