血浆阴离子间隙医学决定水平及临床应用的探讨

The exploration on the medical decisive standard of plasma anion gap and its clinical application

目的 为了探讨血浆阴离子间隙 (AG)在不同疾病时的医学决定水平及其临床应用价值。方法 用 90 3K/Na/Cl离子选择电极对 4 5 0例患者及 1 0 0例健康人进行了血浆电解质测定。结果 恶性肿瘤手术治疗组、恶性肿瘤非手术治疗组、代偿性肺心病组及糖尿病无酸中毒组与健康组AG无显著性差异 (P >0 .0 5 ) ;肾功能衰竭组、糖尿病合并酸中毒组AG均数极其显著高于健康组 (P <0 .0 1 )肝硬化组极其显著低于健康组 (P <0 .0 1 ) ;急性黄胆性肝炎组显著低于健康组 (0 .0 1 <P <0 .0 5 )。结论 建立不同疾病的AG值医学决定水平 ,用以判断酸碱平衡失调是一项很好的指标 ,尤其对糖尿病合并酸中毒的鉴别诊断和肾功能衰竭的预后判断上有较高的价值。AG值可作为室内电解质检测质控的手段之一。

Objective To explore the medical decisive standard of plasma anion gap (AG) in different diseases and its clinical value.Methods Plasma electrolyte was measured in 450 patients and 100 normal people by 903K/Na/Cl ion selecting electrode. Results No significant difference was observed in malignant tumor treated group and non treatad group,compensatory pulmonary disease group, diabetes non acid poisoning group and healthy group ( P >0 .05); AG average in kidney exhaustion group and diabetes with acid poisoning group was remarkably higher than in healthy group ( P <0.01), lives sclerosis group markedly lower than healthy group ( P <0.01); acute jaundice hepatitis group greatly lower than healthy group (0.01< P <0.05).Conclusions It is a very good index to establish the medical decisive standard of AG value in different disease to judge the balance disorder of acid and alkali. It is of great value ,especially for the diagnosis of diabetes acid poisoning and prognosis judgement of kidney exhaustion. AG value can be used as one of approaches for indoor elecytolyte to detect quality control.