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腹水白


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腹水白通常我们采用蛋白浓度、细胞数等等一些指标判断腹水性质,但这已经过时不止十年! 1992年, Runyon 就在内科学年鉴上发表文章指出血浆腹水白蛋白梯度(Serum-Ascites Albumin Gradient, SAAG)是用于判断渗出或漏处性质,更为可靠的指标。SAAG=血清白蛋白浓度 - 同步腹水白蛋白浓度。若小于11g/L则提示渗出液,反之提示为漏出。具体解释如下:

 

The serum-ascitic albumin gradient correlates directly with portal pressure, and patients with gradients greater than or equal to 1.1 g/dl have portal hypertension (transudative ascites) and patients with gradients lesser than 1.1 g/dl do not (exudative ascites). The total protein concentration of ascitic fluid and LDH activity has been traditionally used to classify ascitic fluid in exudate or transudate but they are not so accurated as SAAG. See Table 2 with the classification of types of ascites according to the level of the serum-ascitic albumin gradient .

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