慢性肺心病复合型酸碱失衡血乳酸、丙酮酸水平的研究

本文对104例次慢性肺心病并发碱酸失衡患者进行血气分析,测定血钾,钠,氯和乳酸、丙酮酸含量以及阴离子空隙(AG)。结果血乳酸含量>2mmol/L 者62例(59.6%),>5mmol/L 者9例(8.6%)。丙酮酸含量>0.14者35例(33.7%)。L/P比值>21者37例(35.6%)。其中,呼酸合并代酸和呼酸合并代碱,代酸两组的 AG 值>20mmol/L,血乳酸含量均值5mmol/L,提示肺心病合并复合型酸碱失衡者,除应用预计值代偿公式和 AG 值外,测定血乳酸、丙酮酸含量是判断代酸的一项重要指标。

STUDY ON LACTIC ACID AND PYRUVATE LEVEL IN BLOOD IN PATIENTS WITH CHRONIC COR PULMONALE COMPLICATED MIXED ACIDBASE DISORDERS

One hundred and four arterial blood gas analyses,electrolytes (K, Na, Cl) and lactic acid,pyruvate levels in serum,and anion gaps were determined simultaneously in the patients with chronic cot pulmonale. The results showed that blood lactic acid level was more than 2 mmol/L in 62 cases (59.6%),5 mmol/L in 9 cases (8.6%).Blood pyruvate level was more than 0.14 mmol/L in 35 cases (33.7%),L/P ratio was more than 21 in 37 cases (35.6%).However,both in the groups of re- spiratory acidosis complicated metabolic acidosis and in the group of respiratory acidosis complicated metabolic alkalosis and metabolic aci- dosis,anion gap values increased (>20 mmol/L) and blood lactic acid mean values were about 5 mmol/L.It indicated that on the basis of pre- dicated compensatory equation and anion gap,measuring blood lactic ac- id and pyruvate level is very important for diagnosis of chronic cor pul- monale complicated metabolic Acidosis.