检验医学与临床2024，Vol.21Issue(14)：1985-1990,1995,7.DOI:10.3969/j.issn.1672-9455.2024.14.001
肝硬化腹水相关实验室检查:从指南到临床实践
Related laboratory detections for liver cirrhosis ascites:from guidelines to clinical practice
摘要
Abstract
Ascites is the most common complication of liver cirrhosis,which affects the patients'prognosis and quality of life.Early selection of reasonable ascites detection indexes is the basis for clinicians to make the most appropriate individual diagnosis and treatment decisions,and is also an important basis for improving the diagnosis and treatment effect of ascites in liver cirrhosis.Based on the Guidelines for the Diagnosis and Treat-ment of ascites in Cirrhosis 2023 Edition revised by the Hepatology Branch of the Chinese Medical Association in 2023,the recommendations for the diagnosis and treatment of liver cirrhosis ascites,spontaneous peritonitis and acute kidney injury hepatorenal syndrome is proposed.In this paper,the indicators of laboratory tests re-lated to ascites are interpreted in detail,and the important clinical significance of timely abdominal puncture for conducting ascites cytological analysis,total protein and albumin determination(serum-ascites albumin gradient,SAAG),ascites bacteria and fungi culture,and laboratory tests of renal function(serum creatinine,estimated glomerular filtration rate,etc.)were emphasized.It summarizes main new technologies in related ascites detection in recent years,such as droplet digital PCR method,metagenomic next-generation sequencing(mNGS),and new biomarkers for renal injury such as neutrophil gelatinase-associated lipocalin and kidney in-jury molecule-1 in the diagnosis and treatment of cirrhosis-related ascites and its complications.In the future,the significance of simple random urine Na+/K+determination or combined with new biomarkers in the clini-cal management of ascites deserves attention.In clinical work,it is still necessary for clinicians to fully under-stand and apply the opinion recommended by this guideline,from reality,on the one hand,reasonable indica-tors of ascites examination should be selected to provide the evidence for the most appropriate individual diag-nosis and treatment decision.On the other hand,it is also necessary for clinicians to explore and validate the new biomarkers to continuously improve the diagnosis and treatment level of liver cirrhosis ascites.关键词
肝硬化/腹水/自发性腹膜炎/急性肾损伤/生物标志物Key words
liver cirrhosis/ascites/spontaneous peritonitis/acute renal injury/biomarker分类
医药卫生引用本文复制引用
黄宇文,丁惠国..肝硬化腹水相关实验室检查:从指南到临床实践[J].检验医学与临床,2024,21(14):1985-1990,1995,7.基金项目
首都卫生发展科研专项(2022-1-2181). （2022-1-2181）
