阴离子间隙测定在急性肾衰竭诊治及预后中的应用

Application of Anion Gap Assay for Clinical Diagnosis and Prognosis of Acute Renal Failure

目的 探讨阴离子间隙 (AG)和电解质变化在急性肾衰竭诊治及预后临床意义。方法 87例急性肾衰竭的临床资料及实验室检查结果 ,并按AG高低分成 3组 ,分析AG与代谢性酸中毒的关系 :按预后分为恢复组和死亡组 ,分析AG与预后的关系。结果 AG组代谢性酸中毒率 (80 .8% ) ,高于正常 ,低AG值组 (P <0 .0 5) ;治疗后恢复组的AG水平能够恢复正常 ,而死亡组AG水平仍然高 ,两组比较差异有显著性 (P <0 .0 1 ) ;AG水平恢复与否与急性肾衰竭预后具有一定的关系 ;血 pH、Cl-变化在判断预后无临床意义。 结论 在急性肾衰竭患者诊疗过程中阴离子间隙的监测有助于了解病情、判断酸碱平衡紊乱及进一步判断其预后。

Objective To explore the clinical significance of anion gap (AG) and change of electrolyte in clinical diagnosis and prognosis of acute renal failure (ARF). Methods The clinical data and the results of laboratory examination in 87 acute renal failure patients were analyzed. They were divided into three groups based on anion gap (AG), and to study the relationship between AG and metabolic acidosis. Furthermore, they were divided into two groups based on prognosis to study the relationship between AG and prognosis. Results There was significant difference between the groups of high AG, normal AG and low AG (P<0.05). In the group of high AG, The rate of metabolic acidosis was higher than in other groups. The level of AG in recovery patients was normal after treatment, but in death patients it was still high, the difference was significant in two groups (P<0.01). The recovery of AG was correlated with the prognosis of acute renal failure (ARF). Meanwhile, there was no significance in the change of pH and levels of Cl-. Conclusions AG was a valuable marker for its simplicity, convenience and utility. The monitoring of AG is helpful in the judging ARF patient's condition, disturbance of acid-base balance and prognosis.