Gurubacharya D L, Mathura K C, Karki D B
Department of Medicine, Kathmandu Medical College Teaching Hospital, Nepal.
Kathmandu Univ Med J (KUMJ). 2005 Oct-Dec;3(4):327-33.
We sought to determine the correlation between the level of serum-ascites albumin concentration gradient (SAAG) and the complications of portal hypertension (PHTN), manifested by the presence and grade of esophageal varices (EV).
Our study included 32 patients with ascites, demonstrated by ultrasonography, who had measurement of the SAAG. All had upper gastrointestinal endoscopy with assessment of the presence and size of EV. High SAAG was considered to be present when SAAG was >=1.1 g/dl and Low SAAG when it measured < 1.1 g/dl.
We found that 25 of 32 (78.13%) patients had High SAAG and 7 of 32 (21.87%) had Low SAAG. Esophageal varices were present in 18 of 25 (72%) patients with High SAAG and in none of 7 (0%) patients with Low SAAG (p =<0.001). Among patients with High SAAG, EV were present in four of 8 patients (50%) with SAAG values of 1.10-1.49g/dl; in four of seven patients (57.1%) with SAAG values of 1.50-1.99g/dl; and in ten of ten (100%) with SAAG values of >=2.0g/dl (p = 0.037). The size of the esophageal varices had no association with the level of SAAG in patients with High SAAG (p = 0.426).
In patients with ascites the presence of esophageal varices is associated only with patients with High SAAG. The presence of EV in patients with ascites and High SAAG is directly related to the degree of SAAG. The size of the EV in patients with ascites and High SAAG is not associated with the degree of SAAG.
我们试图确定血清腹水白蛋白浓度梯度（SAAG）水平与以食管静脉曲张（EV）的存在及分级所表现出的门静脉高压（PHTN）并发症之间的相关性。
我们的研究纳入了32例经超声检查证实有腹水且测量了SAAG的患者。所有患者均接受了上消化道内镜检查，以评估EV的存在及大小。当SAAG≥1.1 g/dl时被认为存在高SAAG，当测量值<1.1 g/dl时为低SAAG。
我们发现32例患者中有25例（78.13%）为高SAAG，32例中有7例（21.87%）为低SAAG。25例高SAAG患者中有18例（72%）存在食管静脉曲张，而7例低SAAG患者中无一例存在（0%）（p≤0.001）。在高SAAG患者中，SAAG值为1.10 - 1.49g/dl的8例患者中有4例（50%）存在EV；SAAG值为1.50 - 1.99g/dl的7例患者中有4例（57.1%）存在；SAAG值≥2.0g/dl的10例患者中有10例（100%）存在（p = 0.037）。在高SAAG患者中，食管静脉曲张的大小与SAAG水平无关（p = 0.426）。
在腹水患者中，食管静脉曲张的存在仅与高SAAG患者相关。腹水且高SAAG患者中EV的存在与SAAG程度直接相关。腹水且高SAAG患者中EV的大小与SAAG程度无关。
