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犬猫酸碱平衡及其紊乱的现代研究方法。

Contemporary approach to acid-base balance and its disorders in dogs and cats.

作者信息

Sławuta P, Nicpoń J, Skrzypczak P

机构信息

Department of Internal Diseases with Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland.

出版信息

Pol J Vet Sci. 2010;13(3):561-7.

Abstract

The issue of the acid-base balance (ABB) parameters and their disorders in pets is rarely raised and analysed, though it affects almost 30% of veterinary clinics patients. Traditionally, ABB is described by the Henderson-Hasselbach equation, where blood pH is the resultant of HCO3- and pCO2 concentrations. Changes in blood pH caused by an original increase or decrease in pCO2 are called respiratory acidosis or alkalosis, respectively. Metabolic acidosis or alkalosis are characterized by an original increase or decrease in HCO3- concentration in the blood. When comparing concentration of main cations with this of main anions in the blood serum, the apparent absence of anions, i.e., anion gap (AG), is observed. The AG value is used in the diagnostics of metabolic acidosis. In 1980s Stewart noted, that the analysis of: pCO2, difference between concentrations of strong cations and anions in serum (SID) and total concentration of nonvolatile weak acids (Atot), provides a reliable insight into the body ABB. The Stewart model analyses relationships between pH change and movement of ions across membranes. Six basic types of ABB disorders are distinguished. Respiratory acidosis and alkalosis, strong ion acidosis, strong ion alkalosis, nonvolatile buffer ion acidosis and nonvolatile buffer ion alkalosis. The Stewart model provides the concept of strong ions gap (SIG), which is an apparent difference between concentrations of all strong cations and all strong anions. Its diagnostic value is greater than AG, because it includes concentration of albumin and phosphate. The therapy of ABB disorders consists, first of all, of diagnosis and treatment of the main disease. However, it is sometimes necessary to administer sodium bicarbonate (NaHCO3) or tromethamine (THAM).

摘要

宠物酸碱平衡(ABB)参数及其紊乱问题很少被提及和分析,尽管它影响了近30%的兽医诊所患者。传统上,ABB由亨德森-哈塞尔巴赫方程描述,其中血液pH值是HCO3-和pCO2浓度的结果。由pCO2最初升高或降低引起的血液pH值变化分别称为呼吸性酸中毒或碱中毒。代谢性酸中毒或碱中毒的特征是血液中HCO3-浓度最初升高或降低。在比较血清中主要阳离子与主要阴离子的浓度时,会观察到明显的阴离子缺失,即阴离子间隙(AG)。AG值用于代谢性酸中毒的诊断。20世纪80年代,斯图尔特指出,对pCO2、血清中强阳离子和阴离子浓度之差(SID)以及非挥发性弱酸总浓度(Atot)的分析,能可靠地洞察机体的ABB。斯图尔特模型分析了pH变化与离子跨膜移动之间的关系。区分出六种基本类型的ABB紊乱。呼吸性酸中毒和碱中毒、强离子酸中毒﹑强离子碱中毒、非挥发性缓冲离子酸中毒和非挥发性缓冲离子碱中毒。斯图尔特模型提出了强离子间隙(SIG)的概念,它是所有强阳离子和所有强阴离子浓度之间的明显差异。其诊断价值大于AG,因为它包括白蛋白和磷酸盐的浓度。ABB紊乱的治疗首先包括对主要疾病的诊断和治疗。然而,有时有必要给予碳酸氢钠(NaHCO3)或三羟甲基氨基甲烷(THAM)。

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