血清腹水白蛋白梯度与渗漏出液概念临床价值的比较  

Comparision of Clinical Value Between Serum-ascites Albumin Gradient and the Concept of Exudate-transudate

作　　者：傅明健 王水芳[2] 杨正兵[2] 向丹沙[3] 

机构地区：[1]四川省平武县人民医院,622550 [2]四川大学华西医院,成都610041 [3]四川省宣汉县中医医院,636150

出　　处：《职业卫生与病伤》2003年第4期247-248,共2页Occupational Health and Damage

摘　　要：目的　研究血清腹水白蛋白梯度 (SAAG)与传统渗漏出液概念对腹水病因诊断的准确率及差异。方法　比较SAAG与传统的判断渗漏出液的指标在A、B组之间的差异 ,以及两者在B组内即腹腔恶性肿瘤组及结核性腹膜炎组之间的差异。结果　门脉高压相关组SAAG为 ( 2 0 3± 4 2 )g/L ,非门脉高压相关组SAAG为 ( 7 8± 2 7)g/L ,SAAG对门脉高压诊断的敏感度为 92 % ,特异度为98% ,其阴性预测率为 93 % ,阳性预测率为 96% ,诊断准确率为 95 %。其他指标的诊断准确率分别为 :腹水总蛋白 78% ,腹水白蛋白 80 % ,腹水比重 74% ,腹水血清总蛋白比值 87% ,有核细胞计数 73 % ,腹水乳酸脱氢酶 61% ,均明显低于SAAG。结论　血清腹水白蛋白梯度有望成为评价渗漏出液更灵敏、更有效的生化指标。Objective To sudy the accuray rate of etiological diagnosis for ascites with serum-ascites albumin gradient(SAAG) and the concept of exudate-transudate and compare the differences between them. Methods The differences were compared between SAAG and the traditional exudate-transudate index in group A and group B,the cavum abdominis malignant tumor and the tuberculous peritonitis,in group B. Results SAAG inortal-hypertension-related group was(20.3 ±4.2)g/L,that in non-portal-hypertension-related group being(7.8±2.7)g/L. The diagnosis sensitivity of SAAG was 92%,specificity 98%. The negotive predetermination rate was 93%,positive 96%,and the accuray rate of diagnosis was 95%. The accuray rates of diagnosis with other indices were 78% for ascites total protein and 80% for ascites albumin,74% for ascites specific gravity,87% for proportionality total protein ascites serum, 73% for countingand 61% for scites lactic dehydrogenase respectively. All were significantly lower than that with SAAG.Conclusion Serum-ascites albumin gradient (SAAG) are more sensitive and more operative markers for evaluating the concept of exudate-transudate.

关 键 词：血清腹水白蛋白梯度 渗漏出液 概念 临床价值 腹水 病因诊断 腹腔恶性肿瘤 结核性腹膜炎 

分 类 号：R442.5[医药卫生—诊断学]