Joseph Jose, Badrinath Padmanabhan, Basran Gurnam S, Sahn Steven A
Department of Internal Medicine, Faculty of Medicine & Health Science, UAE University, Al Ain, UAE.
BMC Pulm Med. 2002 Mar 22;2:1. doi: 10.1186/1471-2466-2-1.
To determine the accuracy of serum-effusion albumin gradient (SEAG) and pleural fluid to serum albumin ratio (ALBR) in the diagnostic separation of pleural effusion into transudate and exudate and to compare SEAG and ALBR with pleural fluid LDH (FLDH) the most widely used test.
Data collected from 200 consecutive patients with a known cause of pleural effusion in a United Kingdom district general hospital.
The median and inter quartile ranges (IQR) for SEAG 93.5 (33.8 to 122.5) g/dl, ALBR 0.49 (0.42 to 0.62) and FLDH 98.5 IU/L(76.8 to 127.5) in transudates were significantly lower than the corresponding values for exudates 308.5 (171 to 692), 0.77 (0.63 to 0.85), 344 (216 to 695) all p < 0.0001. The Area Under the Curve (AUC) with 95% confidence intervals (Cl) for SEAG, ALBR and FLDH were 0.81 (0.75 to 0.87), 0.79 (0.72 to 0.86) and 0.9 (0.87 to 0.96) respectively. The positive likelihood ratios with 95%CI for FLDH, SEAG, and ALBR were: 7.3(3.5-17), 6.3(3-15) 6.2(3-14) respectively. There was a significant negative correlation between SEAG and ALBR (r= -0.89, p < 0.0001).
The discriminative value for SEAG and ALBR appears to be similar in the diagnostic separation of transudates and exudates. FLDH is a superior test compared to SEAG and ALBR.
确定血清-胸水白蛋白梯度（SEAG）和胸水与血清白蛋白比值（ALBR）在鉴别诊断胸腔积液为漏出液和渗出液中的准确性，并将SEAG和ALBR与应用最广泛的检测指标胸水乳酸脱氢酶（FLDH）进行比较。
收集英国一家地区综合医院200例已知胸腔积液病因患者的数据。
漏出液的SEAG中位数及四分位数间距（IQR）为93.5（33.8至122.5）g/dl，ALBR为0.49（0.42至0.62），FLDH为98.5 IU/L（76.8至127.5），显著低于渗出液的相应值308.5（171至692）、0.77（0.63至0.85）、344（216至695），所有p<0.0001。SEAG、ALBR和FLDH的曲线下面积（AUC）及95%置信区间（CI）分别为0.81（0.75至0.87）、0.79（0.72至0.86）和0.9（0.87至0.96）。FLDH、SEAG和ALBR的95%CI阳性似然比分别为：7.3（3.5 - 17）、6.3（3 - 15）、6.2（3 - 14）。SEAG与ALBR之间存在显著负相关（r = -0.89，p<0.0001）。
在鉴别诊断漏出液和渗出液方面，SEAG和ALBR的鉴别价值似乎相似。与SEAG和ALBR相比，FLDH是一项更优的检测指标。
