一例因代谢性碱中毒导致慢性呼吸衰竭的库欣综合征病例。

A case of Cushing's syndrome associated with chronic respiratory failure due to metabolic alkalosis.

作者信息

Tanaka M, Yano T, Ichikawa Y, Oizumi K

机构信息

First Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan.

出版信息

Intern Med. 1992 Mar;31(3):385-90. doi: 10.2169/internalmedicine.31.385.

DOI:10.2169/internalmedicine.31.385

PMID:1611192

Abstract

A case of Cushing's syndrome associated with chronic respiratory failure is presented. Although arterial blood gas analysis showed severe metabolic alkalosis, hypoxemia and mild hypercapnia, the patient had no evidence of pulmonary disease or neuromuscular disorder. Voluntary hyperventilation and inhalation of 100% oxygen (O2) revealed normalized arterial oxygen tension (PaO2). Following the recovery from metabolic alkalosis by the treatment with potassium chloride, PaO2 was elevated and arterial carbon dioxide tension (PaCO2) was lowered. Therefore, it was strongly suggested that the main cause of chronic respiratory failure was compensatory alveolar hypoventilation as a response to metabolic alkalosis.

摘要

本文报告一例库欣综合征合并慢性呼吸衰竭的病例。尽管动脉血气分析显示严重代谢性碱中毒、低氧血症和轻度高碳酸血症，但该患者无肺部疾病或神经肌肉疾病的证据。自主过度通气和吸入100%氧气（O2）后，动脉血氧分压（PaO2）恢复正常。经氯化钾治疗代谢性碱中毒恢复后，PaO2升高，动脉血二氧化碳分压（PaCO2）降低。因此，强烈提示慢性呼吸衰竭的主要原因是作为对代谢性碱中毒的反应而出现的代偿性肺泡通气不足。