Zhao L, Luo Y
Hua Xi Yi Ke Da Xue Xue Bao. 1994 Jun;25(2):196-9.
The blood-gas and electrolytes of 427 blood samples from patients with COPD and acid-base imbalance were analysed. The results showed that 14 types of acid-base imbalance were present in patients with COPD and the anion gap decreased in 8 types of acid-base imbalance, especially in respiratory acidosis, metabolic alkalosis and coexistence of both. The anion gap in respiratory acidosis and metabolic alkalosis were 0.8 +/- 6.6mmol/L and 2.1 +/- 7.3mmol/L, respectively. The anion gap in respiratory acidosis with metabolic alkalosis was negative. In all patients the HCO3- increased, and the total anion and total cation diminished. The anion gap decreased owing to the diminution of unmeasured anion. Clinically, the criterion for judging metabolic acidosis with increased anion gap is a value of anion gap over 16 mmol/L. But in case respiratory acidosis (or metabolic alkalosis) and metabolic acidosis coexist in a patient, the anion gap for judging metabolic acidosis should be decreased appropriately.
对427例慢性阻塞性肺疾病（COPD）合并酸碱失衡患者的血样进行血气和电解质分析。结果显示，COPD患者存在14种酸碱失衡类型，其中8种酸碱失衡类型的阴离子间隙降低，尤其是在呼吸性酸中毒、代谢性碱中毒以及两者并存时。呼吸性酸中毒和代谢性碱中毒时的阴离子间隙分别为0.8±6.6mmol/L和2.1±7.3mmol/L。呼吸性酸中毒合并代谢性碱中毒时阴离子间隙为负值。所有患者的HCO3-升高，总阴离子和总阳离子减少。阴离子间隙降低是由于未测定阴离子减少所致。临床上，判断阴离子间隙升高的代谢性酸中毒的标准是阴离子间隙值超过16mmol/L。但如果患者同时存在呼吸性酸中毒（或代谢性碱中毒）和代谢性酸中毒，则判断代谢性酸中毒的阴离子间隙应适当降低。
