血清-腹水白蛋白梯度在腹水病因鉴别诊断中的价值  

Value of serum albumin gradient in differential diagnosis of ascitic etiologies

作　　者：彭玄杰 

机构地区：[1]浙江省台州市第一人民医院消化科,台州318020

出　　处：《临床医学》2007年第3期20-21,共2页Clinical Medicine

摘　　要：目的探讨血清-腹水白蛋白梯度(SAAG)在腹水病因鉴别中的应用价值。方法回顾性分析以腹水待查入院的124例患者的病史,按出院诊断分为门静脉高压相关疾病组(70例)和非门静脉高压相关疾病组(54例);以同一天测定的血清白蛋白水平和腹水白蛋白水平计算SAAG,比较两组SAAG与诊断的关系。结果门静脉高压相关疾病组的SAAG[(24±7)g/L]显著高于非门静脉高压相关疾病组[(8±4)g/L](P<0.01)。以SAAG≥11 g/L为界限值,诊断门静脉高压相关性腹水的敏感性为95.7%,特异性为98.1%,准确性为96.8%,阳性预期值为98.5%,阴性预期值为94.6%。结论SAAG鉴别法的鉴别符合率明显高于传统腹水鉴别法,但不能取代腹水有核细胞计数和细胞学等检查。联合检测能有效提高腹水原因诊断准确率。Objective To evaluate the diagnostic value and reliability of SAAG and other laboratory examinations in patients with ascites. Methods One hundred and twenty - four patients with ascites were reviewed retrospectively. The patients were divided into 2 groups,the group associated with portal hypertension （70 patients） and the group without portal hypertension （ 54 patients）. SAAG was calculated using the serum and ascitic albumin levels on the same day. Results The mean level and standard deviation of SAAG of the group associated with portal hypertension and the group without portal hypertension was （24 ± 7 ） g/L and （8 ±4）g/L（ P 〈0.01 ）. Using SAAG ≥ 11 g/L as the cut - off value,the diagnostic sensitivity for ascites associated with portal hypertension was 95.7% ,diagnostic specificity was 98. 1% ,diagnostic accuracy was 96.8% ,positive predictive value was 98.5% ,negative predictive value was 94. 6%. Conclusion The coincidence rate of SAAG differentiation method is evidently higher than the traditional aseites differentiation methods, but it cant instead of the detection of aseitie haryoteg number and cytological detection. Therefore, the associated detection of the two motheds would effectively increase the accurate rate of the diagnosis of the eouse of aseities.

关 键 词：腹水 血清-腹水白蛋白梯度 鉴别诊断 

分 类 号：R446.19[医药卫生—诊断学]