血清-腹水白蛋白梯度、腹水/血清总胆红素比值联合检测对腹水性质的鉴别诊断价值  

Value of combined detection of serum-ascites albumin gradient and ascitic/serum total bilirubin ratio in the differential diagnosis of ascites

作　　者：沈永坚 梁碧珊 周少雄 何彩云 黄泽棋 谢伟贤 邹林 SHEN Yongjian;LIANG Bishan;ZHOU Shaoxiong;HE Caiyun;HUANG Zeqi;XIE Weixian;ZOU Lin(Foshan Hospital Affiliated to Southern Medical University,&Foshan Second Peoples Hospital,Foshan 528000,Guangdong,China)

机构地区：[1]南方医科大学附属佛山医院/佛山市第二人民医院,广东佛山528000

出　　处：《武汉大学学报（医学版）》2021年第2期292-295,共4页Medical Journal of Wuhan University

基　　金：佛山市十三五医学重点专科建设项目(编号:FSZDZK135026)。

摘　　要：目的:探讨血清-腹水白蛋白梯度(SAAG)、腹水/血清C-反应蛋白(CRP)、腹水/血清总胆红素(TBil)三种指标在不同性质腹水鉴别诊断中的价值。方法:收集2017至2018年在佛山市第二人民医院行腹腔穿刺术患者145例的血清和腹水样本,并将样本分为2组,即漏出液组57例,渗出液组88例。同步测定血清-腹水白蛋白梯度、腹水/血清CRP、腹水/血清总胆红素,并将结果进行比较分析。结果:与漏出液组相比,渗出液组SAAG低于漏出液组,而渗出液组腹水/血清TBil比值高于漏出液组(P<0.05)。受试者工作特征曲线(ROC)分析显示,SAAG区分漏出液和渗出液的曲线下面积(AUC)为0.678,腹水/血清TBil区分漏出液和渗出液的AUC为0.703。两者联合的AUC为0.709。结论:血清-腹水白蛋白梯度、腹水/血清总胆红素比值可以作为鉴别腹水性质的可靠指标。Objective: To investigate the diagnostic value of combined serum ascites albumin gradient(SAAG), ascitic/serum CRP ratio, and ascitic/serum total bilirubin(TBil)ratio in ascites.Methods:A total of 145 ascites cases were collected in Foshan Second People′s Hospital from 2017 to 2018, including 57 patents in transudative group and 88 patients in exudative group. SAAG, ascitic/serum CRP ratio, and ascitic/serum TBil ratio were detected.Results: Compared with that respectively in transudative ascites group, the level of SAAG level in exudative ascites group were higher, while the level of ascitic/serum TBil ratio were lower. ROC analysis showed that the area under the curve(AUC) of SAAG and ascites/serum TBil ratio to differentiate and transudative ascites was 0. 678 and703, respectively. The combination of them reached a AUC of 0. 709.Conclusion: SAAG and ascitic/serum TBil ratio can be a reliable biomarker in the differential diagnosis of ascites.

关 键 词：腹水 漏出液 渗出液 血清-腹水白蛋白梯度 腹水/血清CRP 腹水/血清Tbil 

分 类 号：R446.1[医药卫生—诊断学]