含有机酸的阴离子间隙计算公式与酸碱平衡关系的研究

Study on the relationship of acid-base balance and anion gap calculation formula containing organic acid

目的通过建立含有机酸的阴离子间隙测定公式,研究该项指标在代谢性酸中毒的诊断价值。方法把原来只含有Na^+、HCO_3^-、Cl^-的阴离子间隙计算公式加上乳酸、β-羟丁酸、乙酰乙酸和无机磷的计算公式,分别测定128例正常人及代谢性酸中毒患者104例阴离子间隙,并进行比较。结果使用公式AG_4在诊断肾功不全代谢性酸中毒灵敏度为66．1%,使用AG_1+AG_2诊断酮症酸中毒灵敏度为93．7%,使用AG,诊断乳酸性酸中毒灵敏度为56．5%。结论使用含有有机酸的阴离子计算公式对诊断代谢性酸中毒患者具有较高的灵敏度。

Objective To establish anion gap calculation formula containing organic acid and to study its diagnostic value in metabolic acidosis. Methods We established a new anion gap calculation formula by adding lactic acid（LA） , β - hydroxybutyric（β- HBD）, acetoacetic acid（ACAC） and inorganic phosphorus（ P） to the old one with Na ＋ , HCO3^- and Cl^-. Anion gap of 104 patients with metabolic acidosis were compared with 128 healthy people. Results Diagnostic sensitivity of AG4 was 66.1% in renal insufficiency , AG1 ＋ AG2 was 93.7% in ketoacidosis and AG3 was 56.5% in lactic acidosis. Conclusion There is high diagnostic sensitivity for metabolic acidosis patients with anion gap calculation formula containing organic acid.