糖尿病酮症酸中毒时阴离子间隙的改变及其临床价值

Clinical significance of anion gap change in diabetic ketoacidosis

对16例糖尿病酮症酸中毒病人(DKA)血阴离子间隙(AG)进行了观察,均高于正常值,死亡2例△AG分别为22mmol/L与29.7mmol/L,△AG>AHCO_3,14例康复者AG明显下降(P<0.05),其中4例AG≥30mmol/L病人在恢复过程中△AG>△HCO_3转换为△AG<AHCO_3。对DKA病人AG的测定结合以△AG与△HCO_3相关关系的变化有助于判断DKA的严重程度、治疗效果与预后。

Anion gap (AG) was determined in 16 patients with diabetic ketoacidosis (DKA). It was found to be higher than normal in all patients.△ AG was 22 mmol/L and 29. 7 mmol/L respectively in two patients who died (△AG>△HCO_3). In the 14 survivors, among whom four were found to have an AG≥30mmol/L, AG was significantly decreased after treatment (P<0. 05) and a change of △AG>△HCO_3 to △AG<△HC0_3 was seen during convalescence. AG determination combined with the change of correlation between △AG and △HCO_3 will help evaluate the severity,the response to the treatment and the prognosis of DKA.