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目的探讨血清-腹水白蛋白梯度(SAAG)与门脉高压的关系,评价SAAG对预测门脉高压性食管静脉曲张破裂出血的价值。方法60例肝硬化腹水患者通过胃镜检查分为食管静脉曲张破裂出血组(22例)和非出血组(38例),测定两组SAAG值并进行比较,同时比较不同Child分级的患者其SAAG值的差异。结果60例患者SAAG均﹥11g/L,出血组SAAG[(21.14±3.62)g/L]明显高于非出血组[(15.03±1.60)g/L],有显著性差异(P﹤0.001)。3组不同Child分级的患者其SAAG值分别为Child A组(13.50±1.23)g/L,Child B组(17.40±2.72)g/L,Child C组(22.74±2.73)g/L,3组比较有显著性差异(P﹤0.05)。22例SAAG为11.0～14.9g/L的患者中存在静脉曲张者6例(27.3%),17例SAAG为15.0～19.9g/L的患者中存在静脉曲张者11例(64.7%),21例SAAG﹥20g/L的患者中有静脉曲张者17例(81.0%),3组比较有显著性差异(P﹤0.001)。结论食管静脉曲张的存在与高SAAG有关,SAAG与肝功能受损程度有关。SAAG对预测肝硬化食管静脉曲张破裂出血有一定的临床价值。
Objective To investigate the relationship between serum-ascitic albumin gradient (SAAG) and portal hypertension and to evaluate the value of SAAG in predicting portal hypertension esophageal variceal bleeding. Methods Sixty patients with cirrhosis and ascites were divided into esophageal variceal bleeding group (n = 22) and non-hemorrhagic group (38 group) by gastroscopy. The SAAG values of the two groups were measured and compared, and the SAAG values The difference. Results SAAG was (21.14 ± 3.62) g / L in bleeding group was significantly higher than that in non-bleeding group (15.03 ± 1.60 g / L), SAAG was> 11g / L in 60 patients (P <0.001) . The SAAG values in three groups with different Child grading were 13.50 ± 1.23g / L in Child A group, 17.40 ± 2.72g / L in Child B group and 22.74 ± 2.73g / L in Child C group, respectively There was significant difference (P <0.05). Among the 22 patients with SAAG ranging from 11.0 to 14.9 g / L, 6 (27.3%) had varicose veins, and 11 (64.7%) had varicose veins in 17 patients with SAAG ranging from 15.0 to 19.9 g / L, 21 Seventeen patients (81.0%) had varicose veins in patients with SAAG> 20g / L, there were significant differences among the three groups (P <0.001). Conclusion The presence of esophageal varices is associated with high SAAG, and SAAG is related to the degree of liver dysfunction. SAAG has certain clinical value in predicting the risk of esophageal variceal bleeding due to cirrhosis.