肝硬化并发症患者血清-腹水白蛋白梯度与肝功能分级关系的研究  

Study of the relationship between serum-ascites albumin gradient and liver function grade in patients with hepatic cirrhosis

作　　者：张鸣[1] 李政伟 杨柳青[1] 陈建婷[1] 

机构地区：[1]西安医学院第二附属医院消化内科,西安710038 [2]陕西省神木市医院感染科,陕西神木719300

出　　处：《新疆医科大学学报》2017年第12期1537-1539,共3页Journal of Xinjiang Medical University

基　　金：陕西省教育厅科学研究项目(12JK1032)

摘　　要：目的探讨肝硬化患者血清-腹水白蛋白梯度(SAAG)与食管胃底静脉曲张破裂出血、肝性脑病(HE)、肝功能分级的关系。方法选择2015年4月-2016年4月在西安医学院第二附属医院住院的肝硬化腹水患者共85例,根据入院时的临床表现和Child-Pugh评分标准进行HE分期和肝功能分级,根据是否出现食管胃底静脉曲张破裂出血分为出血组(46例)和未出血组(39例),测定2组患者SAAG的差异,分析SAAG与食管胃底静脉曲张破裂出血、HE、肝功能分级的相关性。结果出血组SAAG水平为(23.52±1.63)g/L,未出血组SAAG水平为(12.34±2.45)g/L,2组比较差异有统计学意义(P<0.05)。与Ⅰ期相比,Ⅱ、Ⅲ和Ⅳ期患者SAAG水平明显升高,Ⅲ和Ⅳ期患者SAAG水平明显高于Ⅱ期,差异均有统计学意义(P<0.05)。与A级相比,B、C级SAAG水平明显升高,C级的SAAG水平明显高于B级,差异均有统计学意义(P<0.05)。结论 SAAG与患者肝功能减退程度密切相关,且对预测食管胃底静脉曲张破裂出血、判断HE严重程度具有一定的临床价值。Objective To analysis the relationship among serum-ascites albumin gradient(SAAG),esophageal-gastric fundus variceal bleeding,hepatic encephalopathy(HE)and liver function grade in patients with hepatic cirrhosis.Methods By retrospective analysis,85 cases with cirrhotic ascites form the Second Affiliated Hospital of Xi'an Medical University during April in 2015 to April in 2016 were studied.HE stages and liver function grade were observed according to the clinical manifestation after admission and ChildPugh score.And then they were divided into bleeding group(46 patients)and non bleeding group(39 patients)according to esophageal-gastric fundus variceal bleeding.The correlation of SAAG to esophagealgastric fundus variceal bleeding,HE and liver function grade were determined.Results The levels of SAAG in bleeding group was(23.52±1.63)g/L,while in non bleeding group was(12.34±2.45)g/L,there was statistically significant between the two groups(P <0.05).The levels of SAAG of stageⅡ,Ⅲ and Ⅳ were significantly increased compared with that of stageⅠ,and the levels of SAAG of stage Ⅲand Ⅳ were significantly increased compared with that of stageⅡ(P <0.05).The levels of SAAG of stage B and C were significantly increased compared with that of stage A,and the level of stage C was significantly increased compared with that of stage B(P <0.05).Conclusion SAAG is closely associated with liver function,which has clinical value to predict esophageal-gastric fundus variceal bleeding and evaluate the severity of HE.

关 键 词：肝硬化 血清-腹水白蛋白梯度 并发症 肝功能分级 

分 类 号：R575.2[医药卫生—消化系统]