Valicenti P A, Torino M L, Osatinsky R, Huberman E D
Acta Gastroenterol Latinoam. 1986;16(2):81-92.
Sixty six patients with ascites of different etiologies were studied. Both serum and peritoneal fluids were examined through proteic electrophoresis, being the haemopexin determined in the peritoneal fluids. Immunoglobulins usually show high values in neoplastic effusions, especially igG (x +/- ES = 928.57 +/- 86.87 mg/dl) and IgA (x +/- ES = 157 +/- 17.84 mg/dl). However, the highest determinations were found in those of the congestive heart failures. The quotients obtained from the ascites immunoglobulin/serum immunoglobulin ratio are useful from a statistics point of view, though their practical value is limited. No plasma/ascites correlation was observed either in cirrhotic or in neoplastic patients. Quantification of haemope in proved to be conclusive in differential diagnosis. The 100% of benign ascites (cirrhosis, congestive heart failure and kidney failure) showed lower values than 170 mg/dl while 90.5% of neoplastic patients showed higher figures than said value. The average was 30.79 +/- 5.31 mg/dl for cirrhotic patients and 205.19 +/- 9.62 mg/dl for neoplastic patients with a statistically significative different for both groups (p less than 0.001). There is a high probability that its determination could show the etiology of the process. It was useful not only in cases of both neoplastic and cirrhotic ascites but also in those which had a cardiac origin, in which it showed intermediate values (mean +/- ES = 83.75 +/- 15.77 mg/dl). We feel that its incorporation to the routine followed when studying peritoneal effusions will afford a quick etiologic orientation.
对66例不同病因的腹水患者进行了研究。通过蛋白质电泳对血清和腹水进行检测,并测定腹水中的血红素结合蛋白。免疫球蛋白在肿瘤性积液中通常显示高值,尤其是IgG(x±ES = 928.57±86.87mg/dl)和IgA(x±ES = 157±17.84mg/dl)。然而,在充血性心力衰竭患者中测定值最高。从腹水免疫球蛋白/血清免疫球蛋白比值获得的商数从统计学角度来看是有用的,但其实际价值有限。在肝硬化或肿瘤患者中均未观察到血浆/腹水的相关性。事实证明,血红素结合蛋白的定量在鉴别诊断中具有决定性作用。100%的良性腹水(肝硬化、充血性心力衰竭和肾衰竭)显示的值低于170mg/dl,而90.5%的肿瘤患者显示的值高于该值。肝硬化患者的平均值为30.79±5.31mg/dl,肿瘤患者为205.19±9.62mg/dl,两组之间存在统计学显著差异(p<0.001)。很有可能其测定可以显示该病程的病因。它不仅在肿瘤性和肝硬化性腹水病例中有用,而且在心脏源性腹水病例中也有用,在这些病例中它显示出中间值(平均值±ES = 83.75±15.77mg/dl)。我们认为,将其纳入研究腹水时的常规检查中,将有助于快速进行病因学诊断。