Zilva J F
Ann Clin Biochem. 1978 Jan;15(1):40-3. doi: 10.1177/000456327801500111.
Anaerobic glycolysis produces lactate, ATP, and water but there is no net change in the number of hydrogen ions: it does not produce lactic acid. The acidosis usually associated with hyperlactataemia is caused by hydrolysis of the ATP, with release of hydrogen ions. By contrast, ATP turnover by aerobic mechanisms is not acidifying because the released hydrogen ion is reutilised as more ATP is formed. Gluconeogenesis from lactate does not utilise hydrogen ions directly--in fact, it produces them. The associated net H+ utilisation is caused by the aerobic generation of the ATP and GTP required to drive glycolysis in reverse. It is suggested that only by understanding these important biochemical facts can the clinician found his diagnosis and treatment on a firm, rational basis.
无氧糖酵解产生乳酸、三磷酸腺苷（ATP）和水，但氢离子数量没有净变化：它不产生乳酸。通常与高乳酸血症相关的酸中毒是由ATP水解并释放氢离子引起的。相比之下，有氧机制的ATP周转不会导致酸化，因为随着更多ATP的形成，释放的氢离子会被重新利用。由乳酸进行的糖异生并不直接利用氢离子——实际上，它会产生氢离子。相关的净氢离子利用是由驱动糖酵解逆向进行所需的ATP和鸟苷三磷酸（GTP）的有氧生成引起的。有人认为，只有理解这些重要的生化事实，临床医生才能在坚实、合理的基础上进行诊断和治疗。
