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[慢性重型肝炎患者酸碱平衡特点:126例分析]

[Characteristics of acid-base balance in patients with chronic severe hepatitis: analysis of 126 cases].

作者信息

Li Xue-mei, Li Yu-xian, Meng Qing-hua, Duan Zhong-hui, Hou Wei, Li Juan

机构信息

Beijing You'an Hospital, Capital University of Medical Sciences, Beijing 100069, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Aug 15;86(30):2131-3.

Abstract

OBJECTIVE

To investigate the characteristics of acid-base balance in patients with chronic severe hepatitis.

METHODS

Samples of venous blood and arterial blood were collected from 126 patients with chronic severe hepatitis, 106 males and 20 females, aged 44 +/- 13 (25 - 74), to undergo measurement of the potassium, sodium, and chloride ions, and urea nitrogen and creatine, blood electrolytes and blood gas analysis respectively.

RESULTS

Acid-base disturbance (ABD) was found in 115 of the 126 patients (91.3%). 40 of the 115 patients with ABD (31.7%) had respiratory alkalosis combined with metabolic alkalosis, 32 of them (25.4%) had respiratory alkalosis combined with metabolic acidosis; 28 of them (22.2%) had pure respiratory alkalosis, and 8 (6.3%) had pure metabolic acidosis. Five patients had triple acid-base disturbance, 4 of which had respiratory alkalosis (combined with metabolic alkalosis and metabolic acidosis, 3.2%), and 1 of which had respiratory acidosis (combined with metabolic alkalosis and metabolic acidosis, 0.8%). There was no significantly difference in the prevalence rates of pure acid-base disturbance and multiple acid-base disturbances between the patients with cirrhosis-base chronic severe hepatitis and those with chronic hepatitis-based chronic severe hepatitis. Hypoxia symptoms were seen in 34 patients (27%). 103 patients died. All the 15 patients with their blood pH < 7.35 died.

CONCLUSION

ABD in the patients with chronic severe hepatitis is mainly alkalosis with respiratory alkalosis as the basic ABD type. The appearance of ABD is not associated with the underlying illness. Patients of chronic severe hepatitis often suffer from hypoxia. Low blood pH is an important factor causing death.

摘要

目的

探讨慢性重型肝炎患者酸碱平衡特点。

方法

收集126例慢性重型肝炎患者的静脉血和动脉血样本,其中男性106例,女性20例,年龄44±13(25 - 74)岁,分别检测钾、钠、氯离子、尿素氮和肌酐,进行血液电解质及血气分析。

结果

126例患者中115例(91.3%)存在酸碱紊乱(ABD)。115例ABD患者中,40例(31.7%)为呼吸性碱中毒合并代谢性碱中毒,32例(25.4%)为呼吸性碱中毒合并代谢性酸中毒;28例(22.2%)为单纯呼吸性碱中毒,8例(6.3%)为单纯代谢性酸中毒。5例患者存在三重酸碱紊乱,其中4例为呼吸性碱中毒(合并代谢性碱中毒和代谢性酸中毒,3.2%),1例为呼吸性酸中毒(合并代谢性碱中毒和代谢性酸中毒,0.8%)。肝硬化基础上的慢性重型肝炎患者与慢性肝炎基础上的慢性重型肝炎患者单纯酸碱紊乱及多重酸碱紊乱患病率差异无统计学意义。34例患者(27%)出现缺氧症状。103例患者死亡。15例血pH<7.35的患者全部死亡。

结论

慢性重型肝炎患者的ABD以碱中毒为主,呼吸性碱中毒为基本的ABD类型。ABD的出现与基础疾病无关。慢性重型肝炎患者常伴有缺氧。低血pH是导致死亡的重要因素。

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