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[目的]探讨血清-腹水清蛋白梯度(SAAG)在腹水病因诊断中的价值。[方法]回顾性分析以腹水待查入院的60例患者的病史,按出院诊断分为门脉高压组(41例)和非门脉高压组(19例),测定血清和腹水总蛋白(TP)、清蛋白(Alb)、乳酸脱氢酶(LDH),并进行对比。[结果]门脉高压组SAAG为(18.46±5.24)g/L,非门脉高压组为(8.26±4.02)g/L,2组比较差异有统计学意义(P<0.01)。对门脉高压诊断的准确率SAAG为93.33%,腹水TP为71.67%,腹水、血清TP比值为80.00%,腹水LDH为73.33%。此外,SAAG≥11 g/L的患者食管静脉曲张的发生率高。[结论]SAAG对腹水病因诊断优于传统的渗漏出液指标,对鉴别门脉高压性与非门脉高压性腹水具有重要的临床价值,但不能取代腹水有核细胞数和细胞学等检查。联合检测能有效提高腹水病因诊断准确率。
[Objective] To investigate the value of serum-ascites albumin gradient (SAAG) in etiological diagnosis. [Methods] The clinical data of 60 patients with ascites admitted to hospital were retrospectively analyzed. The patients were divided into portal hypertension group (n = 41) and non-portal hypertension group (n = 19) ), Albumin (Alb), lactate dehydrogenase (LDH), and compared. [Results] The SAAG of portal hypertension group was (18.46 ± 5.24) g / L, and that of non-portal hypertension group was (8.26 ± 4.02) g / L. There was significant difference between the two groups (P <0.01). The diagnostic accuracy of portal hypertension was 93.33%. The ascites TP was 71.67%. The ascites, serum TP ratio was 80.00%, and ascites LDH was 73.33%. In addition, patients with SAAG ≥ 11 g / L have a high incidence of esophageal varices. [Conclusion] SAAG is superior to the traditional diagnosis of leakage of fluid in the diagnosis of ascites, and has important clinical value in differentiating portal hypertension from non-portal hypertension ascites, but it can not replace the examination of ascites nucleated cells and cytology . Joint detection can effectively improve the diagnosis of ascites etiology.