[血清腹水白蛋白梯度的诊断价值]

Zhu Xiao-han, Liu Bin, Cheng Zong-yong

Department of Internal Medicine, Second Xiangya Hospital, Central South University, Changsha 410011, China.

Hunan Yi Ke Da Xue Xue Bao. 2003 Jun;28(3):278-80.

OBJECTIVE

To evaluate the diagnostic value and efficacy of the serum-ascites albumin gradient (SAAG).

METHODS

One hundred and thirty six patients with ascites fluid were divided into 5 groups: cirrhosis group (Group A, 42 cases), hepatocellular carcinoma group (Group B, 20 cases), spontaneous peritenitis group (Group C, 10 cases), tuberculous peritenitis group (Group D, 40 cases), and periteneal carcinomatosis group (Group E, 24 cases). Group A, B, and C all had portal hypertension. Ascites fluid from paracentesis was analyzed before the treatment.

RESULTS

The ascites total protein (ATP) concentration in Group A, B, and C was less than 25 g/L but was more than 25 g/L in Group D and E. SAAG was more than 11 g/L in Group A, B, and C but less than 11 g/L in Group D and E. There was significant difference between the high SAAG group (> or = 11.0 g/L) and the low SAAG group (P < 0.01). PMN count was less than 250 x 10(6)/L in Group A, B, and E but more than 250 x 10(6)/L in Group C and D. There was no significant difference between Group C and D (P = 0.662).

CONCLUSION

SAAG demonstrates that patients with ascites fluid possess the basis of portal hypertension. PMN count represents infective ascites. SAAG combined with PMN can effectively enhance the diagnostic value of ascites fluid tests. SAAG classification can be considered to be a novel standard in ascites fluid analysis.

目的

评估血清-腹水白蛋白梯度（SAAG）的诊断价值及效能。

方法

将136例腹水患者分为5组：肝硬化组（A组，42例）、肝细胞癌组（B组，20例）、自发性腹膜炎组（C组，10例）、结核性腹膜炎组（D组，40例）和腹膜癌病组（E组，24例）。A、B、C组均有门静脉高压。治疗前对腹腔穿刺抽取的腹水进行分析。

结果

A、B、C组腹水总蛋白（ATP）浓度低于25 g/L，而D组和E组高于25 g/L。A、B、C组SAAG大于11 g/L，而D组和E组小于11 g/L。高SAAG组（≥11.0 g/L）与低SAAG组之间差异有统计学意义（P<0.01）。A、B、E组中性粒细胞计数低于250×10⁶/L，而C组和D组高于250×10⁶/L。C组和D组之间差异无统计学意义（P = 0.662）。