强离子隙等指标在 ICU 中的应用探讨

目的：探讨继 pH、阴离子隙（AG）后的第三代方程式产生的强离子隙（SIG）在危重症患者中的临床应用价值。方法在测定血气、血生化结果基础上，应用 Stewart-Figge 方法学的方程式计算 SIG。结果（1）危重症患者各组 K＋、Na＋、HCO3-、AG、pH、PO43-、ALB、SIG 及 Cr 水平与对照组比较差异有统计学意义（P ＜0．05）。（2）死亡组与非死亡组 SIG 均值的比值为3．04，差别最大，两组间 AG 和 Cr 的比值次之。结论SIG 作为一个新的指标在与其他生化、血气指标如 HCO3-、AG、pH、PO43-、Cr 及乳酸联合应用时，能更好地反映危重病患者的酸碱紊乱情况，对预测疾病发展趋势有较强的指示作用。

Application of strong ion gap and other indicators in ICU

Objective To investigate the clinical application value of strong ion gap（SIG）generated by the third generation equa-tion following pH and the anion gap（AG）in critically ill patients.Methods On the basis of the determination results of blood gas and blood biochemistry,the equation in the Stewart-Figge methodology was adopted to calculate SIG.Results （1）There were sta-tistically significant differences in K＋ ,Na＋ ,HCO3 - ,AG,pH,PO4 3 - ,ALB,SIG and Cr between the critical illness groups and the control group（P 〈0.05）.（2）The SIG mean value ratio the death group to non-death group was 3.04,the difference was the big-gest,P 〈0.05,AG and Cr took the second place.Conclusion SIG as a new indicator in combination with other biochemical and blood gas indicators,such as the HCO3 - ,AG,pH,PO4 3 - ,Cr and lactic acid can reflect the situation of the acid-base disorders in critically ill patients and plays a strong indicative role in predicting the disease development trends.