血清腹水白蛋白梯度预测食管胃底静脉曲张破裂出血的研究

目的：研究血清腹水白蛋白梯度与门脉高压的相 关性，探讨血清腹水白蛋白梯度对食管胃底静脉曲张破 裂出血的预测价值。方法：将2010年5月至2012年6月在 我院住院的42例肝硬化腹水患者纳入研究，测定所有入 组患者的血清腹水白蛋白梯度值，同时均予胃镜检查以 明确有无食管胃底静脉曲张或破裂出血。根据测得的 SAAG值，把42例患者以11 g/L为界限分为高SAAG组36例 和低SAAG组6例。根据胃镜结果，所有患者中有14例并发 食管-胃底静脉曲张破裂出血，另外28例未发生出血，比 较两组患者的SAAG值。结果：高SAAG的36例患者中有食 管胃底静脉曲张的27例，占69．23％；低SAAG的6例患者 中发生食管胃底静脉曲张的有1例，占16．67％；高SAAG 组发生食管胃底静脉曲张的比率明显高于低SAAG组（ P ＜0．05）。14例发生食管胃底静脉曲张破裂出血者测得 SAAG值为（23．97±6．95）g/L，28例未发生出血的患 者测得SAAG值为（18．12±5．92）g/L，发生食管胃底 静脉曲张破裂出血患者的SAAG值明显高于未发生出血者 （ P＜0．05）。结论：血清腹水白蛋白梯度值的高低与 食管胃底静脉曲张的发生呈正相关，可通过检测血清腹 水白蛋白梯度值来预测食管胃底静脉出血情况。

Study on Ascites Serum Albumin Gradient Predict Esophageal and Gastric Varices Bleeding

To study the serum ascites albumin gradient correlation with portal hypertension , and to explore the value of serum ascites albumin gradient predict esophageal and gastric varices bleeding . Method：42 patients with liver cirrhosis ascites from May 2010 to June 2012 in our hospital were included in the study,determinate all the groups of patients with ascites serum albumin gradient value, at the same time, all to gastroscope inspection in order to make clear whether the esophageal varicose veins or gastric bleeding . According to the measured values of SAAG, 42 patients with 11g/L for boundary was divided into high SAAG group（36 cases）and low SAAG group （6 cases）.According to the results of gastroscope, 14 cases of all patients complicated with esophageal and gastric varices bleeding , and other 28 cases with hemorrhage oc-curs, compared two the SAAG value groups of patients.Results： In 36 patients with high SAAG 27 cases with ophageal gastric varices, accounting for 69.23%;6 patients of low SAAG had 1 cases with esophageal gastric varices,accounting for 16.67%;High SAAG group occurrence rate of esophageal gastric varices was higher than low SAAG group （ P〈0 .05 ） .SAAG value of 14 cases with esophageal and gastric varices bleed-ing were measured （23.97±6.95）g/L, SAAG value of 28 cases without hemorrhage occurs measured was （18.12±5.92） g/L, SAAG of ccurred in patients with esophageal and gastric varices bleeding is obviously higher than not bleeding （ P〈0.05） .Conclusion：High or low of ascites serum albumin gradient value are positively correlated with the occurrence of esophageal gastric varices, but through the detection of serum as-cites albumin gradient values can predict esophageal and gastric varices bleeding.