血清-腹水白蛋白梯度和腹水ADA、CA125在结核性腹膜炎患者中的临床意义

目的:探讨血清-腹水白蛋白梯度(serum-ascites albumin gradient,SAAG)和腹水腺苷脱氨酶(adenosine deam-inase,ADA)、CA125对结核性腹膜炎的诊断价值。方法:选取302例腹水患者进行回顾性分析,并将其分为4组:单纯渗出性结核性腹膜炎组(A1组)34例,肝硬化合并结核性腹膜炎组(A2组)16例,肝硬化组(B组)204例和其他原因组(C组)48例。以所有患者同一日血清白蛋白及腹水中的白蛋白浓度进行检测,计算出SAAG;并测定腹水中的ADA、CA125浓度。结果:A1组、A2组、B组、C组患者SAAG分别为7.05±1.35、8.56±2.15、21.35±3.65和18.43±2.72 g/L;腹水ADA分别为57.02±10.65、52.31±9.54、10.15±2.60和15.67±4.26 U/L;腹水CA125分别为475±22.51、408±15.36、261±28.15和656±26.37 U/L;结果显示:SAAG在A1组与B组间、A2组与B组间比较差别均有统计学意义(P0.05);A1组与A2组之间差别均无统计学意义(P0.05)。腹水ADA在A1组与B组间、A2组与B组间差别均有统计学意义(P0.05),A1组与A2组间比较差别均无统计学意义(P0.05),A1组与A2组抗结核2周后复查,治疗前后腹水ADA差别均有统计学意义(P0.05);腹水CA125在A1组与B组间、A2组与B组之间差别均无统计学意义(P0.05),但A1组与A2组抗结核2周后复查,腹水CA125差别均有统计学意义(P0.05)。结论:腹水ADA对诊断结核性腹膜炎有很好的敏感性、特异性和准确率,并可作为判断结核性腹膜炎抗结核疗效的观察指标。SAAG可作为诊断结核性腹膜炎的敏感指标,但特异性较低。腹水CA125对结核性腹膜炎没有诊断价值,但是可以作为一项判断结核性腹膜炎疗效追踪的观察指标。

Diagnostic value of serum-albumin gradient and ascites fluid adenosine deaminase,CA125 in tuberculous peritonitis

Objective:To study the diagnostic value of serum-ascites albumin gradient(SAAG) and ascities fluid adenosine deaminase(ADA),CA125 in tuberculous peritonitis.Methods:302 patients with ascites were selected to be retrospectively analyzed,which were divided into four groups:purely exudative tuberculous peritonitis(group A1,n=34),cirrhosis combined with tuberculous peritonitis(group A2,n=16),cirrhosis(group B,n=204) and others(group C,n=48).The SAAG were calculated by detecting of the levels of serum albumin an...