5-氧脯氨酸致高阴离子间隙代谢性酸中毒的综述文章。

A Review Article on 5-Oxoproline Induced High Anion Gap Metabolic Acidosis.

机构信息

Ain Shams University, Cairo, Egypt.

Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.

出版信息

S D Med. 2021 Oct;74(10):468-470.

Abstract

In 1989, an acquired high anion gap metabolic acidosis due to elevated 5-oxoproline (pyroglutamic acid) was first reported. This is related to chronic acetaminophen use in malnourished patients and women with chronic medical conditions, it could happen even using therapeutic or low doses. The mainstay of treatment is cessation of acetaminophen use along with the administration of intravenous fluids. N-acetyl cysteine might accelerate improvement. The best explanation of the disorder is glutathione depletion and activation of a key enzyme in the γ-glutamyl cycle. This review article aims to highlight the mechanism and management of acquired high anion gap metabolic acidosis caused by 5-oxoproline in the adult population.

摘要

1989 年，首次报道了因 5-氧脯氨酸（吡咯烷酮羧酸）升高导致的获得性阴离子间隙升高型代谢性酸中毒。这种情况与慢性营养不良患者和患有慢性疾病的女性中使用对乙酰氨基酚有关，甚至在使用治疗剂量或低剂量时也会发生。治疗的主要方法是停止使用对乙酰氨基酚，并同时给予静脉补液。N-乙酰半胱氨酸可能会加速病情的改善。该疾病发生的主要原因是谷胱甘肽耗竭和 γ-谷氨酰循环中的关键酶被激活。本文旨在重点阐述成人 5-氧脯氨酸引起的获得性阴离子间隙升高型代谢性酸中毒的发病机制和治疗方法。