Staikowsky F, Levy I, Guidet B, Gabillet J M, Offenstadt G
Service de réanimation polyvalente, Hôpital Saint-Antoine, Paris.
Ann Fr Anesth Reanim. 1991;10(4):398-400. doi: 10.1016/s0750-7658(05)80817-2.
A 37-year-old chronic alcoholic female was admitted with epigastric pain, complete anorexia, vomiting and diarrhoea. She was dehydrated, and had polypnoea. Laboratory investigations revealed severe metabolic acidosis (pH 7.14) with a major anion gap (37.4 mmol.l-1), and ketone bodies in blood and urine. Blood glucose concentration was 6.1 mmol.l-1, there was no glycosuria. Rehydration (2 l.day-1 of 5% glucose) together with sodium bicarbonate (500 ml of 1.4% sodium bicarbonate over the first four hours) normalized the pH (7.37). The ketone bodies disappeared on the following day. During the acute illness, were found high blood levels of glucagon and low levels of insulin. The diagnosis of alcoholic ketoacidosis, the pathogenesis of which remains unknown, is discussed.
一名37岁的慢性酒精中毒女性因上腹部疼痛、完全厌食、呕吐和腹泻入院。她脱水且呼吸急促。实验室检查显示严重代谢性酸中毒（pH 7.14），伴有较大的阴离子间隙（37.4 mmol.l-1），血液和尿液中均有酮体。血糖浓度为6.1 mmol.l-1，无糖尿。补液（每天2升5%葡萄糖）并给予碳酸氢钠（最初4小时内给予500毫升1.4%碳酸氢钠）使pH值恢复正常（7.37）。酮体在第二天消失。在急性疾病期间，发现血液中胰高血糖素水平升高而胰岛素水平降低。本文讨论了酒精性酮症酸中毒的诊断，其发病机制尚不清楚。
