Khan F Y
Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Singapore Med J. 2007 May;48(5):434-9.
Ascites is common and represents an important feature of liver disease and other diseases. The aim of this study is to determine the causes of ascites in Qatar, and to evaluate the value of ascitic fluid analysis in different types of ascites.
This is a descriptive, prospective study of all patients admitted to the medical department at Hamad General Hospital with ascites between January 2004 and January 2005.
Of the 104 patients enrolled in the study, 70 (67.3 percent) were males and 34 (32.7 percent) were females, with a mean age of 52.9 (+/-14.8) years. Liver cirrhosis was the most frequent cause of ascites in 62 patients (59.6 percent), while chronic alcoholism was the main cause of liver cirrhosis. Other frequent causes of ascites were malignant ascites in 12 patients (11.5 percent), malignancy-related ascites in ten patients (9.6 percent), and tuberculous peritonitis in eight patients (7.7 percent). Based on the serum-ascites albumin gradient (SAAG), different causes of ascites were divided into two main groups. The first group was characterised by a mean SAAG of 1.1 or higher, and the second group was characterised by a mean SAAG of less than 1.1. The most common cause of high gradient ascites was liver cirrhosis, while the most common causes of low gradient ascites were carcinomatous peritonitis and tuberculous peritonitis. The mean ascitic lactate dehydrogenase (LDH) level was higher in cancer patients than in tuberculous patients (p-value is less than 0.05), while the mean ascitic glucose concentration was significantly lower in peritoneal tuberculosis than in carcinomatous peritonitis (p-value is less than 0.05).
Liver cirrhosis is the main cause of ascites in Qatar. SAAG is a better distinguishing marker for separating ascites related to portal hypertension from other causes of ascites without portal hypertension. In patients with low gradient ascites, ascitic fluid glucose and LDH level are useful indicators for separating tuberculous from malignant ascites.
腹水很常见，是肝脏疾病及其他疾病的一个重要特征。本研究旨在确定卡塔尔腹水的病因，并评估腹水分析在不同类型腹水中的价值。
这是一项对2004年1月至2005年1月期间因腹水入住哈马德总医院内科的所有患者进行的描述性前瞻性研究。
该研究纳入的104例患者中，男性70例（67.3%），女性34例（32.7%），平均年龄52.9（±14.8）岁。肝硬化是62例（59.6%）患者腹水最常见的病因，而慢性酒精中毒是肝硬化的主要病因。其他常见的腹水病因包括12例（11.5%）恶性腹水、10例（9.6%）恶性肿瘤相关腹水和8例（7.7%）结核性腹膜炎。根据血清腹水白蛋白梯度（SAAG），不同病因的腹水分为两个主要组。第一组的特征是平均SAAG为1.1或更高，第二组的特征是平均SAAG低于1.1。高梯度腹水最常见的病因是肝硬化，而低梯度腹水最常见的病因是癌性腹膜炎和结核性腹膜炎。癌症患者腹水中乳酸脱氢酶（LDH）的平均水平高于结核患者（p值小于0.05），而结核性腹膜炎患者腹水中葡萄糖的平均浓度显著低于癌性腹膜炎患者（p值小于0.05）。
肝硬化是卡塔尔腹水的主要病因。SAAG是区分与门静脉高压相关的腹水和其他无门静脉高压病因的腹水的更好鉴别标志物。在低梯度腹水患者中，腹水葡萄糖和LDH水平是区分结核性腹水和恶性腹水的有用指标。
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