肺心病三重酸碱失衡诊断的临床探讨

A clinical study on diagnosis of chronic pulmonary heart disease complicated with triple acid-base disorders

本文对12例肺心病呼酸型三重酸碱失衡的患者进行研究,结果提示当疑诊有呼酸合并代酸时,血乳酸含量是一项重要指标,通常应高于5mmol/L,当呼酸合并代酸并疑诊有代碱时应测定血浆“潜在”HCO-_3含量,通常大于AB预计代偿值或高于45mmol/L,当呼酸合并代碱并疑诊有代酸时,除血浆AG值应大于20mmol/L才有诊断代酸的价值外,强调测定血乳酸含量。此外AG值在17mmol/L～20mmol/L范围时,不能完全除外有无代酸,应结合血乳酸含量综合诊断。

Study on 12 cases with chronic pulmonary heart disease (CPHD) associated with triple acid-base disorders indicated that blood lactate level(>5retool/L) and 'potential' bicarbonate level were importent parameters, when respiratory acidosis was complicated with metabolic acidosis, potential blood bicarbonate level should be higher than AB predicated value or more than 45 mmol/L, when metabolic acidosis was doubted in a patient with respirazory acidosis complicated with alkalosis, AG value should be more than 20 mmol/L and/or blood lactate level was more than 5mmol/L. It was emphasized that if AG value was from 17 to 20 mmol/L, blood lactate level would be measured to avoid any mistake of diagnosis.