Value of serum-ascitic albumin gradient in the diagnosis of ascitic etiologies

Objective: To study the value of serum-ascitic albumin gradient(SAAG) in the diagnosis of ascitic etiologies.Methods: 89 patients with ascites were reviewed retrospectively.The patients were divided into 2 groups: the group associated with portal hypertension(47 patients)and the group without portal hypertension(42 patients).Tested the total protein in and albumin in serum and ascitesd and analyze these parameters.Results:The mean level and standard deviation in SAAG of the group with portal hypertension and the group without portal hypertension was18.42±5.48 g/L,and 8.07±3.25 g/L,respectively(P0.001).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ascitic diagnosis by SAAG in portal hypertension group were 93.6%(44/47),97.6%(41/42),95.5%(85/89),97.8%(44/45),93.2%(41/44)respectively.All these indexes were significant higher than the results by diagnosing exudates and transndates with ascites fluid total protein(AFTP)(P0.05).Conclusion: There is significant clinical value for SAAG in identifying ascites fluid of portal hypertension from non portal hypertension.High SAAG is related to portal hypertension,so the patients with low SAAG need further investigation to find the presence of probable malignant tumor、tuberculous peritonitis and autoimmune disease.