Graber M L, Quigg R J, Stempsey W E, Weis S
Ann Intern Med. 1983 May;98(5 Pt 1):607-9. doi: 10.7326/0003-4819-98-5-607.
A patient with overt lipemia presented with hyponatremia, hyperchloremia, and a negative anion gap. The hyperchloremia and negative gap resulted from overestimation of chloride levels due to a light-scattering effect in the colorimetric assay, an effect that was reproducible in vitro. In a prospective study, this effect produced substantial overestimations at even modest degrees of hyperlipemia. This effect expands the differential diagnosis of a decreased gap, adds to the list of technique-dependent artifacts in lipemia, and, if present, must be recognized for a patient's fluid and electrolyte status to be accurately defined.
一名患有明显脂血症的患者出现低钠血症、高氯血症和阴离子间隙为负值的情况。高氯血症和阴离子间隙负值是由于比色法中光散射效应导致氯离子水平被高估所致，这种效应在体外可重现。在一项前瞻性研究中，即使在血脂轻度升高的情况下，这种效应也会导致显著的高估。这种效应扩展了阴离子间隙降低的鉴别诊断范围，增加了脂血症中依赖技术的假象清单，并且如果存在，必须加以识别才能准确界定患者的液体和电解质状态。
