[不明原因代谢性酸中毒的诊断]
[Diagnosis in metabolic acidosis of unknown origin].
作者信息
Hovda Knut Erik, Hunderi Odd Helge, Øvrebø Steinar, Jacobsen Dag
机构信息
Akuttmedisinsk avdeling, Medisinsk divisjon, Ullevål universitetssykehus, 0407 Oslo.
出版信息
Tidsskr Nor Laegeforen. 2004 Dec 16;124(24):3203-5.
BACKGROUND
Obtaining a precise diagnosis in patients presenting with metabolic acidosis of unknown origin is difficult. Poisoning with methanol or ethylene glycol should be suspected in cases with a combined increase of osmolal and anion gaps.
MATERIALS AND METHODS
Retrospectively we have compared the methanol and ethylene glycol values in poisoned patients with their osmolal gaps. The anion gaps are compared to the toxic anions measured.
RESULTS
There were good correlations between serum alcohols and osmolal gaps and between toxic metabolites and anion gaps.
INTERPRETATION
The osmolal and the anion gaps are both helpful tools in the diagnosis of patients with metabolic acidosis of unknown origin, especially for identifying patients poisoned with methanol or ethylene glycol.
背景
对不明原因代谢性酸中毒患者进行准确诊断较为困难。在渗透压间隙和阴离子间隙均升高的情况下，应怀疑甲醇或乙二醇中毒。
材料与方法
我们回顾性地比较了中毒患者的甲醇和乙二醇值与其渗透压间隙。将阴离子间隙与所测毒性阴离子进行比较。
结果
血清醇类与渗透压间隙之间以及毒性代谢产物与阴离子间隙之间存在良好的相关性。
解读
渗透压间隙和阴离子间隙都是诊断不明原因代谢性酸中毒患者的有用工具，尤其有助于识别甲醇或乙二醇中毒患者。
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