Wijdicks E F, Hubmayr R D
Department of Neurology, Mayo Clinic Rochester, MN 55905.
Mayo Clin Proc. 1994 Nov;69(11):1044-6. doi: 10.1016/s0025-6196(12)61370-6.
To analyze the acid-base abnormalities in patients with status epilepticus.
We retrospectively reviewed the acid-base disturbances in 38 consecutive patients who had been admitted to the emergency department at a Mayo-affiliated hospital because of status epilepticus between 1982 and 1993.
On the basis of results of arterial blood gas analyses, the acid-base disorders were categorized. In addition, chest roentgenograms and electrocardiograms were reviewed for pulmonary infiltrates and cardiac arrhythmias.
Arterial blood gas analysis performed immediately after admission revealed an acid-base abnormality in 32 of 38 patients (84%). Respiratory acidosis was most common (N = 16; 42%) and occurred either alone or in combination with metabolic acidosis. Pulmonary infiltrates were not more common in patients with respiratory acidosis than in other patients. Although cardiac arrhythmias were more common in patients with respiratory or metabolic acidosis (42%) than in those with respiratory alkalosis or normal blood gas values (36%), this difference was not statistically significant.
We conclude that respiratory acidosis with or without metabolic acidosis is common in patients who have status epilepticus. Respiratory acidosis was not predictive of the final outcome. In our study patients, all acid-base abnormalities resolved spontaneously.
分析癫痫持续状态患者的酸碱异常情况。
我们回顾性分析了1982年至1993年间因癫痫持续状态入住梅奥附属医院急诊科的38例连续患者的酸碱紊乱情况。
根据动脉血气分析结果对酸碱紊乱进行分类。此外，对胸部X线片和心电图进行检查，以观察肺部浸润和心律失常情况。
入院后立即进行的动脉血气分析显示，38例患者中有32例（84%）存在酸碱异常。呼吸性酸中毒最为常见（n = 16；42%），可单独出现或与代谢性酸中毒合并出现。呼吸性酸中毒患者的肺部浸润并不比其他患者更常见。虽然呼吸性或代谢性酸中毒患者的心律失常发生率（42%）高于呼吸性碱中毒或血气值正常的患者（36%），但这种差异无统计学意义。
我们得出结论，伴有或不伴有代谢性酸中毒的呼吸性酸中毒在癫痫持续状态患者中很常见。呼吸性酸中毒不能预测最终结局。在我们的研究患者中，所有酸碱异常均自发缓解。
