血清-腹水白蛋白梯度的诊断价值  

Diagnostic value of serum-ascites albumin gradient

作　　者：朱小寒[1] 刘斌[1] 程宗勇[1] 

机构地区：[1]中南大学湘雅二医院内科,长沙410011

出　　处：《湖南医科大学学报》2003年第3期278-280,共3页Bulletin of Hunan Medical University

摘　　要：目的 :探讨血清 腹水白蛋白梯度 (SAAG)的诊断价值和有效性。方法 :选择腹水患者 1 36例。其中肝硬化 (A组 ) 4 2例 ,原发性肝癌 (B组 ) 2 0例 ,自发性腹膜炎 (C组 ) 1 0例 ,结核性腹膜炎 (D组 ) 4 0例 ,腹膜转移癌 (E组 )2 4例。A ,B ,C三组均具有门静脉高压的病理学基础。分别于治疗前穿刺取腹水送检相应指标。结果 :A ,B和C组的腹水总蛋白的浓度均 <2 5g/L ,而D和E组均 >2 5g/L。A ,B和C组的SAAG均≥ 1 1g/L ,D和E组SAAG则均 <1 1g/L。合并A ,B ,C组为高SAAG(≥ 1 1 .0g/L)组和合并D ,E为低SAAG(<1 1 .0g/L)组后进行组间比较 ,差异具有显著性 (P <0 .0 1 )。A ,B和E组的多形核白细胞计数 (PMN)均 <2 5 0× 1 0 6/L ,C和D组均 >2 5 0× 1 0 6/L ,但C组和D组比较 ,差异没有显著性 (P =0 .6 6 2 )。结论 :SAAG能反映腹水患者是否存在门静脉高压的病理学基础 ,PMN计数能反映是否存在感染。结合SAAG和PMN两种指标 ,能有效提高腹水检测的诊断价值。因此 。Objective To evaluate the diagnostic value and efficacy of the serum ascites albumin gradient (SAAG). Methods One hundred and thirty six patients with ascites fluid were divided into 5 groups: cirrhosis group (Group A, 42 cases), hepatocellular carcinoma group(Group B, 20 cases), spontaneous peritenitis group (Group C, 10 cases),tuberculous peritenitis group (Group D, 40 cases), and periteneal carcinomatosis group (Group E, 24 cases).Group A, B, and C all had portal hypertension. Ascites fluid from paracentesis was analyzed before the treatment. Results The ascites total protein (ATP) concentration in Group A, B, and C was less than 25 g/L but was more than 25 g/L in Group D and E. SAAG was more than 11 g/L in Group A, B, and C but less than 11 g/L in Group D and E. There was significant difference between the high SAAG group (≥11.0 g/L)and the low SAAG group (P<0.01).PMN count was less than 250×10 6/L in Group A, B, and E but more than 250×10 6/L in Group C and D.There was no significant difference between Group C and D (P =0.662).Conclusion SAAG demonstrates that patients with ascites fluid possess the basis of portal hypertension. PMN count represents infective ascites. SAAG combined with PMN can effectively enhance the diagnostic value of ascites fluid tests. SAAG classification can be considered to be a novel standard in ascites fluid analysis.

关 键 词：血清 腹水 白蛋白梯度 诊断 门静脉高压 病理学 

分 类 号：R446.1[医药卫生—诊断学]