Kinney E L, Wright R J, Caldwell J W
Reed Institute, Miami, Florida.
Comput Biol Med. 1989;19(1):55-9. doi: 10.1016/0010-4825(89)90035-8.
The diagnosis of myxedema ascites is often difficult and delayed, from our experience and the reports of other investigators. To address this situation, previous reports on the diagnosis of ascites were pooled in order to distinguish the features of myxedema ascites from other forms of ascites. These features were confined to variables that would be obtained routinely from patients with ascites requiring paracentesis. The data of 26 patients with myxedema ascites, and 61 patients with ascites from another cause were analyzed. Discriminant analysis was used to select the variables that best separated patients into myxedema and non-myxedema groups. The variables selected were if the ascites was straw-colored or with a protein content less than 2.5 g/dl, if the patient was over age 40, and if there was periorbital edema or hepatomegaly. These variables correctly classified 90.8% of patients. However, considering the roughly 1% prevalence of myxedema ascites among patients with ascites, the predictive value of these variables, in combination, is only 8.7%. With this low rate, these variables should probably not be used to screen for myxedema ascites.
根据我们的经验以及其他研究者的报告，黏液性水肿腹水的诊断往往困难且容易延误。为了解决这一情况，我们汇总了此前关于腹水诊断的报告，以便区分黏液性水肿腹水与其他形式腹水的特征。这些特征局限于从需要进行腹腔穿刺术的腹水患者常规获取的变量。我们分析了26例黏液性水肿腹水患者以及61例由其他病因导致腹水患者的数据。采用判别分析来选择能将患者最佳区分为黏液性水肿组和非黏液性水肿组的变量。所选变量包括腹水是否为草黄色或蛋白含量低于2.5g/dl、患者年龄是否超过40岁以及是否存在眶周水肿或肝肿大。这些变量正确分类了90.8%的患者。然而，考虑到腹水患者中黏液性水肿腹水的患病率约为1%，这些变量综合起来的预测价值仅为8.7%。鉴于这一低比率，这些变量可能不应被用于筛查黏液性水肿腹水。
