Hirano K, Koide H
Department of Medicine, Juntendo University School of Medicine.
Nihon Rinsho. 1992 Sep;50(9):2146-51.
Acidosis is the result of the net addition of hydrogen ion to the extracellular space or loss of bicarbonate from that space. Hydrogen ion may be added by the increased production of strong acids, an increase in CO2 concentration, or the addition of exogenous acids. The common approach to the differential diagnosis of metabolic acidosis is to divide the patients into two categories based on whether the anion gap in plasma is increased or not. Metabolic acidosis with normal anion gap (hyperchloremic) suggests that bicarbonate has been effectively replaced by chloride. In contrast, metabolic acidosis with an increased anion gap suggests addition to the body fluids of an acid other than hydrochloric acids or its equivalent.
酸中毒是细胞外液中氢离子净增加或该空间中碳酸氢根离子丢失的结果。氢离子可因强酸生成增加、二氧化碳浓度升高或外源性酸的加入而增加。代谢性酸中毒鉴别诊断的常用方法是根据血浆阴离子间隙是否增加将患者分为两类。阴离子间隙正常的代谢性酸中毒（高氯性）提示碳酸氢根已被氯离子有效替代。相反，阴离子间隙增加的代谢性酸中毒提示除盐酸或其等价物之外的酸加入了体液。
