107例腹水患者腹水中4种指标的检测意义  

Diagnostic value of ADA,LDH,total cholesterol and serum-ascites albumin gradient in ascites of various causes

作　　者：任孟军[1] 廖于[2] 文静[1] 

机构地区：[1]重庆市第三人民医院消化内科,400014 [2]重庆医药高等专科学校基础部,400051

出　　处：《重庆医学》2010年第5期557-559,共3页Chongqing medicine

摘　　要：目的探讨腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、胆固醇(TC)及血清-腹水清蛋白(SAAG)梯度在不同病因腹水中的临床意义。方法对107例腹水患者进行ADA、LDH、TC及SAAG检测,并分析4种指标在不同腹水中的水平及意义。结果肝硬化、自发性腹膜炎、肝细胞癌、腹膜结核及恶性肿瘤性腹水测定值分别为:ADA(4.3±1.2,10.4±2.5,6.2±1.9,32.3±12.8,15.4±7.2)u/L,LDH(51.4±23.2,94.2±38.7,63.1±25.2,174.3±68.6,630.2±281.5)u/L,TC(0.34±0.16,0.60±0.21,0.43±0.18,2.18±0.76,2.30±1.35)mmol/L,SAAG(22.4±6.7,17.4±6.0,20.8±5.3,6.53±3.28,8.27±4.51)g/L。结核性腹水ADA多高于30u/L而LDH多低于400u/L,恶性肿瘤则相反;结核及恶性肿瘤腹水TC均高于1.2mmol/L而SAAG多低于11g/L;肝细胞癌腹水指标接近于肝硬化。结论联合检测ADA、LDH、TC及SAAG对不同病因腹水的鉴别诊断有一定价值。Objective To explore the activity levels of ADA, LDH, total chotesterol（TC）, and serum-ascites albumin gradient （SAAG） in ascites of various causes and to determine the diagnostic value. Methods 107 cases with ascites were recruited, the ADA, LDH,TC level of ascites and SAAG were tested. Results The average level of ADA,LDH,TC and SAAG with liver cirrhosis,spontaneous bacterial peritonitis, liver cirrhosis complicating hepatocellular carcinoma, tuberculous peritonitis and malignant tumors were respectively：ADA（4. 3±1. 2,10. 4±2. 5,6. 2±1. 9,32. 3±12. 8,15. 4±7. 2）u/L,LDH（51. 4±23. 2,94. 2±38. 7,63. 1±25.2,174.3±68.6,630.2±281.5）u/L,TC（0.34±0.16,0.60±0.21,0.43±0. 18,2.18±0.76,2.30±1.35）mmol/L,SAAG （22.4± 6.7,17.4 ± 6.0,20.8 ± 5. 3,6. 53 ± 3. 28,8. 27 ± 4. 51 ） g/L. The overwhelming majority of tuberculous peritonitis held ADA level higher than 30 u/L and LDH level less than 400u/L,whereas the malignant tumors ascites was conversed. The ascites concentration of TC in tuberculous peritonitis and malignant tumors was higher than 1.2 mmol/L, these indicators between liver cirrhosis and hepatocellular carcinoma were approximate. Conclusion The combination of ADA,LDH,TC and SAAG are helpful to differential diagnosis of ascites.

关 键 词：腺苷脱氨酶 乳酸脱氢酶 胆固醇 血清-腹水清蛋白梯度 腹水 

分 类 号：R446.1[医药卫生—诊断学]