血清-腹水白蛋白梯度与食管胃底静脉曲张破裂出血的关系

目的 探讨血清-腹水白蛋白梯度(SAAG)与食管胃底静脉曲张破裂出血的关系.方法 测定34例肝硬化腹水患者SAAG值并行胃镜检查以了解有无食管胃底静脉曲张,以11g/L为界将34例患者分为高SAAG组及低SAAG组,采用Pearson相关分析法分析SAAG与食管胃底静脉曲张之间的关系.34例患者中并发食管胃底静脉曲张破裂出血者10例,非出血者24例,测定两组患者的SAAG值并进行比较.结果 30例高SAAG患者中22例有食管胃底静脉曲张,而4例低SAAG患者均无食管胃底静脉曲张.SAAG与食管胃底静脉曲张存在正相关(r=0.81,P＜0.01)；10例出血组患者SAAG值为(24.18±7.36) g/L,24例非出血组患者其SAAG值为(18.19±6.18) g/L,两组差异有统计学意义(P＜0.05).结论 SAAG与门脉压力密切相关,对预测门脉相关性食管胃底静脉出血有一定临床价值.

Study of the relationship between serum-ascites albumin gradient and esophageal-gastric fundus variceal bleeding

Objective To study the relationship between serum-asicites albumin gradient（SAAG） and the portal hypertensive ascites in order to appreciate the value of SAAG on the prediction of esophageal-gastric fundus variceal bleeding.Methods 34 patients with cirrhotic ascites were examined with endoscopy.The patients were classified as high-gradient group and low-gradient group by the SAAG value of 11g/L.The relationship between SAAG and esophageal-gastric fundus varices was studied by Pearson correlation analyasis.Among the 34 patients studied,10 patients had esophageal-gastric fundus variceal bleeding and 24 patients had no esophageal-gastric fundus variceal bleeding.Results In the 30 patients classified as high-gradient group,22 patients had esophageal-gastric fundus variceas.In the 4 patients classified as low-gradient group,no patient had esophageal-gastric fundus variceas.The results showed the direct correlation between the level of SAAG and the degree of esophageal-gastric fundus variceas （r=0.81,P＜0.01）.The mean level of SAAG in bleeding group,consisting 10 patients,was （24.18±7.36）g/L.The mean level of SAAG in non-bleeding group,consisting 24 patients,was （18.19±6.18）g/L.The results showed significant difference between the bleeding group and non-bleeding group（P＜0.05）.Conclusion There is correlation between the level of SAAG and the portal venous pressure.The level of SAAG is valueable on the prediction of esophageal-gastric fundus variceal bleeding.