Gorman J M, Cohen B S, Liebowitz M R, Fyer A J, Ross D, Davies S O, Klein D F
Arch Gen Psychiatry. 1986 Nov;43(11):1067-71. doi: 10.1001/archpsyc.1986.01800110053007.
Alkalosis is prominent among the many physiologic and biochemical effects of sodium lactate infusion. Though this is partially due to the conversion of lactate to bicarbonate, the metabolic component, it may also be secondary to hyperventilation before and during the infusion, the respiratory component. We analyzed pH, carbon dioxide pressure, bicarbonate, and inorganic phosphate from patients with panic disorder and agoraphobia with panic attacks and from normal controls both before and during lactate infusion. Our findings extend earlier work demonstrating that many such patients are chronic hyperventilators. Both metabolic and respiratory alkalosis develop in all subjects during lactate infusion, but only hyperventilation-induced hypocapnia differentiates patients at the point of lactate-induced panic from nonpanicking patients and normal controls. Finally, low inorganic phosphate levels at baseline appear associated with patients who will panic during the subsequent lactate infusion. This last unexpected finding may reflect hyperventilation or an abnormality in intracellular glycolysis.
碱中毒是输注乳酸钠诸多生理和生化效应中的突出表现。虽然这部分归因于乳酸向碳酸氢盐的转化（代谢成分），但也可能继发于输注前及输注过程中的过度通气（呼吸成分）。我们分析了惊恐障碍和伴有惊恐发作的广场恐惧症患者以及正常对照者在输注乳酸钠之前和期间的pH值、二氧化碳分压、碳酸氢盐和无机磷酸盐。我们的研究结果扩展了早期的研究工作，表明许多此类患者是慢性过度通气者。在输注乳酸钠期间，所有受试者都会出现代谢性和呼吸性碱中毒，但只有过度通气引起的低碳酸血症能将乳酸诱发惊恐发作的患者与未发作的患者及正常对照者区分开来。最后，基线时无机磷酸盐水平低似乎与随后输注乳酸钠时会惊恐的患者有关。这一最后的意外发现可能反映了过度通气或细胞内糖酵解异常。
