血清-腹水白蛋白梯度预测门静脉高压性腹水及食管静脉曲张的界值探讨  

Cutoff values for serum-ascites albumin gradient in predicting portal hypertensive ascites and esophageal varices

作　　者：洪万东[1] 王瑜敏[1] 朱启槐[1] 

机构地区：[1]温州医学院附属第一医院,浙江温州325000

出　　处：《现代实用医学》2010年第11期1224-1226,共3页Modern Practical Medicine

摘　　要：目的探讨血清-腹水白蛋白梯度预测门静脉高压性腹水及食管静脉曲张的最佳诊断界值。方法回顾性分析118例因腹水住院的患者的临床资料,并应用ROC曲线分析血清-腹水白蛋白的梯度诊断门静脉高压性腹水和预测食管静脉曲张的诊断界值。结果血清-腹水白蛋白梯度诊断门静脉高压腹水的最佳诊断界值为17 g/L,敏感度为84.29%,特异度为70.37%,准确度为81.4%。当诊断界值为11 g/L时,敏感度为94.29%,特异度为44.44%,准确度为79.3%。预测食管静脉曲张的最佳诊断界值为18 g/L,敏感度为92.86%,特异度66.67%,准确度为88.24%。结论 与传统的血清-腹水白蛋白梯度界值(11g/L)相比,界值为17 g/L,预测门静脉高压性腹水具有较高的准确度。诊断界值为18g/L时,对食管静脉曲张有一定的预测价值。ObjectiveTo explore cutoff values for serum-ascites albumin gradient on predicting portal hypertensive ascites and varices.Methods 118 cases were included in this retrospective analysis.The cutoff values for serum-ascites albumin gradient in predicting portal hypertensive ascites and esophageal varices were determined by ROC curve.ResultsThe best value was 17 g/L for serum/ascites albumin gradient on predicting portal hypertensive ascites.The diagnostic sensitivity,specificity and accuracy were 84.29%,70.37% and 81.4%,respectively.While the diagnostic sensitivity,specificity and accuracy were 94.29%,44.44% and 79.3%,with a value of 11g/L.With the best cutoff value of 18 g/L,the sensitivity,specificity and accuracy were 92.86%,66.67% and 88.24% on predicting esophageal varices.ConclusionThe serum-ascites albumin gradient has a high diagnostic accuracy with a value of 17g / L than that of 11g/L for predicting portal hypertensive ascites.With a value of 18g/L,the serum-ascites albumin gradient is valuable for predicting esophageal varices.

关 键 词：食管和胃静脉曲张 腹水 门静脉高压 血清-腹水白蛋白梯度 

分 类 号：R57[医药卫生—消化系统]