Goldman J M, Chiriboga M
Department of Medicine, Coney Island Hospital, Brooklyn, New York 11235.
J Emerg Med. 1989 Jul-Aug;7(4):369-72. doi: 10.1016/0736-4679(89)90308-9.
A case of diabetic ketoacidosis presenting with alkalemia (pH, 7.61) instead of acidemia (pH less than 7.35) is discussed. Severe vomiting results in electrolyte depletion and hypovolemia, which in turn results in bicarbonate reabsorption and an alkalemia state despite the presence of ketoacids. Severe respiratory alkalosis can also result in alkalemia. Recognition of the alkalemia and its cause will lead to the institution of appropriate therapy.
本文讨论了一例糖尿病酮症酸中毒患者,其表现为碱血症(pH值为7.61)而非酸血症(pH值小于7.35)。严重呕吐导致电解质耗竭和血容量不足,进而导致碳酸氢盐重吸收,尽管存在酮酸,但仍出现碱血症状态。严重的呼吸性碱中毒也可导致碱血症。认识到碱血症及其病因将有助于采取适当的治疗措施。