Kirschbaum B
Division of Nephrology, Medical College of Virginia, Richmond 23298-0160.
Artif Organs. 1991 Dec;15(6):443-8.
Interpretation of acid-base balance in human physiology relies on the accuracy of the Henderson-Hasselbalch equation governing pH, HCO3- concentration, and dissolved CO2 in blood. The influence of strong ions and plasma proteins is not generally assigned any quantitative importance. We have taken advantage of the electrolyte and acid-base abnormalities of patients with end stage renal failure to explore the interrelationship among these factors as they pertain to pH maintenance. We find a complex association between pH and plasma protein fractions. pH failed to correlate with the strong ion difference, net cationic equivalency of plasma proteins, pCO2, or serum phosphate considered singly or together. The pK1' for the dialysis population differed significantly from 6.10. The largest calculated value was 6.285. This difference was independent of the dialysate buffer anion composition. The loss of CO2 from blood during sample preparation in the clinical laboratory may fully account for the increase in calculated pK1' and may explain why measured venous rather than arterial total CO2 more closely matches the arterial blood gas calculated HCO3-.
人体生理学中酸碱平衡的解释依赖于亨德森 - 哈塞尔巴尔赫方程的准确性，该方程用于控制血液中的pH值、HCO₃⁻浓度和溶解的CO₂。强离子和血浆蛋白的影响通常未被赋予任何定量重要性。我们利用终末期肾衰竭患者的电解质和酸碱异常来探究这些因素与pH维持相关的相互关系。我们发现pH与血浆蛋白组分之间存在复杂的关联。单独或综合考虑时，pH与强离子差、血浆蛋白的净阳离子当量、pCO₂或血清磷酸盐均无相关性。透析人群的pK1'与6.10有显著差异。最大计算值为6.285。这种差异与透析液缓冲阴离子组成无关。临床实验室样本制备过程中血液中CO₂的损失可能充分解释了计算出的pK1'的增加，并且可以解释为什么测量的静脉总CO₂而非动脉总CO₂更接近动脉血气计算出的HCO₃⁻。
