Diagnostic utility of the serum-ascites albumin gradient in Mexican patients with ascites related to portal hypertension.
Diagnostic utility of the serum-ascites albumin gradient in Mexican patients with ascites related to portal hypertension.
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DOI：
10.1002/jgh3.12404
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
González Ojeda A
中科院分区：
文献类型：
--
作者：
Cervantes Pérez E;Cervantes Guevara G;Cervantes Pérez G;Cervantes Cardona GA;Fuentes Orozco C;Pintor Belmontes KJ;Guzmán Ramírez BG;Reyes Aguirre LL;Barbosa Camacho FJ;Bernal Hernández A;González Ojeda A
腹水分析是必要的，以确定病因，并区分门静脉高压症（PH）相关和不相关的腹水。已经研究了许多诊断参数，但没有一个参数完全区分这些。我们的目的是验证血清白蛋白腹水梯度（SAAG）的诊断继发于PH腹水，并建立截断点预测PH使用其敏感性和特异性。这是一项在诊断为任何病因腹水的患者中进行的横断面研究。测量腹水中SAAG和白蛋白浓度（AFA），以确定其用于确定是否存在PH的灵敏度和特异性。根据曲线下面积确定临界点和统计学显著性水平。对87例患者进行了评价，其中74例（84%）为男性，平均年龄为54.0 ± 13.6岁。72例（83%）在入院时诊断为PH相关腹水，15例（17%）诊断为非PH相关腹水。SAAG正确分类48例（67%），但24例（33%）分类错误，而AFA正确分类59例（82%），只有13例（17%）错误。SAAG的诊断准确率为57%，AFA为73%。AFA的敏感性为82%，特异性为66%（95%置信区间[CI]：0.63-0.93），而SAAG的敏感性为66%，特异性为86%（95% CI：0.72-0.95）。SAAG的诊断性能较差，敏感性低，但特异性高。在区分PH和非PH腹水方面，AFA的诊断准确性上级优于SAAG。测定血清白蛋白-腹水梯度（SAAG）和腹水白蛋白浓度（AFA），以确定其诊断门静脉高压症（PH）的敏感性和特异性。SAAG的诊断性能较差，敏感性低，但特异性高。在区分PH和非PH腹水方面，AFA的诊断准确性上级优于SAAG。
Analysis of ascitic fluid is necessary to determine the etiology and to distinguish portal hypertension (PH)‐related and unrelated ascites. Numerous diagnostic parameters have been studied, but no single parameter has completely distinguished these. We aimed to validate the serum albumin–ascites gradient (SAAG) for the diagnosis of ascites secondary to PH and to establish cutoff points to predict PH using its sensitivity and specificity. This was a cross‐sectional study conducted on patients diagnosed with ascites of any etiology. The SAAG and albumin concentration in ascitic fluid (AFA) were measured to establish their sensitivity and specificity for determining the presence or absence of PH. Cutoff points and levels of statistical significance were established based on the area under the curve. Eighty‐seven patients were evaluated, of whom 74 (84%) were men, with an average age of 54.0 ± 13.6 years. Seventy‐two (83%) were diagnosed at admission with PH‐related ascites and 15 (17%) with non‐PH‐related ascites. SAAG correctly classified 48 (67%) patients, but 24 (33%) were classified incorrectly, while AFA classified 59 (82%) correctly and only 13 (17%) incorrectly. The diagnostic accuracy of SAAG was 57 versus 73% for AFA. AFA had a sensitivity of 82% and specificity of 66% (95% confidence interval [CI]: 0.63–0.93), while SAAG had a sensitivity of 66% but a specificity of 86% (95% CI: 0.72–0.95). The SAAG showed poor diagnostic performance with low sensitivity but high specificity. The diagnostic accuracy of AFA is superior to that of SAAG in discriminating between PH and non‐PH ascites. The serum albumin–ascites gradient (SAAG) and albumin concentration in ascitic fluid (AFA) were measured to establish their sensitivity and specificity for determining the presence or absence of portal hypertension (PH). The SAAG showed poor diagnostic performance with low sensitivity but high specificity. The diagnostic accuracy of AFA is superior to that of SAAG in discriminating between PH and non‐PH ascites.
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影响因子：
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作者：
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