血清-腹水白蛋白梯度在鉴别门脉高压性与非门脉高压性腹水中的临床意义

目的探讨血清-腹水白蛋白梯度(SAAG)在腹水鉴别中的临床应用价值。方法选择诊断明确的腹水患者55例,门脉高压41例、非门脉高压14例,测定血清和腹水总蛋白、白蛋白、乳酸脱氢酶、并进行对比。结果门脉高压组SAAG为(17.86±4.66)g/L,非门脉高压组SAAG为(11.05±6.74)g/L,两组比较有显著性差异(P<0.001)。对门脉高压诊断的准确率SAAG为94.55%,腹水总蛋白为61.82%、腹水血清总蛋白比值83.64%,腹水乳酸脱氢酶为67.27%。此外,SAAG大于11 g/L的病人食管静脉曲张的发生率高。结论SAAG对鉴别门脉高压性与非门脉高压性腹水具有重要的临床意义。

Clinical Significence of Serum Ascites Albumin Gradient in Differentiation Ascitic Fluid of Portal Hypertension from Non-portal Hypertension

Objective To evaluate the clinical value of serum ascites albumin gradient(SAAG) in differentiation of ascites.MethodsFifty-five ascites patients,41 with portal hypertension and 14 with nonportal hypertension were studied by biochermical parameters of total protein,albumin,LDH in serum and ascetise.ResultsThe SAAG of the portal hypertension group(11.05±6.74 g/L) was significantly higher than that of the nonportal hypertension group(12.05±6.74 g/L).The diagnostic accuracy of SAAG(94.55%) was higher than that of other parameters(ascites fluid total protein,ascites fluid albumin,ascites fluid to serum total protein ratio,ascites fluid LDH). In addition,the patients with SAAG higher than 11 g/L showed high incidence of esophageal varices(P<0.01).ConclusionThere are significant clinical values for SAAG in distinguishing ascites fluid of portal hypertension from nonportal hypertension.