患有酒精性酸性脂肪酸症的患者的透隙增加
Chelsea V Hayman1, Kyle D Pires1, Emily T Cohen1
1Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA.
Clinical toxicology (Philadelphia, Pa.)
|September 2, 2024
概括
在酒精酸性酸症中,高透隙很常见,往往导致毒性酒精中毒的误诊. 这项研究发现,酒精酸性酸症患者的中位氧化差距为27,这凸显了对准确诊断的需要.
科学领域:
- 毒理学 毒理学 毒理学
- 内部医学 内部医学
- 紧急医疗 紧急医疗
背景情况:
- 奥斯莫尔间隙经常用于诊断有毒酒精中毒.
- 酒精性酸性脂肪酸症可以呈现出升高的奥斯摩尔隙间,模仿有毒酒精中毒.
- 错误的诊断可能导致不必要和潜在的有害治疗.
研究的目的:
- 在被诊断患有酒精性酸性脂肪酸症的患者中,以表征奥斯摩尔缺口的范围.
- 根据奥斯摩尔差距值,区分酒精性酸性和毒性酒精中毒.
- 为了告知诊断策略,并防止误诊.
主要方法:
- 对符合酒精性酸性疾病特定标准的患者进行了回顾性研究.
- 纳入标准:有记录的酒精使用障碍,有类素或升高的β-基酸盐的存在,以及≥14 mmol/L的离子间隙.
- 排除标准:可检测的有毒酒精含量,最近的血液透析或福梅皮佐尔治疗,以及其他导致代谢性酸的原因.
主要成果:
- 55名患者符合酒精酸性酸性疾病的标准.
- 中位数的奥斯莫尔差距为27 (IQR 18-36).
- 82%的患者有透孔>10,44%的患者有透孔>30.
结论:
- 患有酒精酸性酸症的患者经常表现出与有毒酒精中毒中所见的合性隙.
- 准确的区分至关重要,以避免对有毒酒精中毒的不适当治疗.
- 识别酒精酸性酸性的奥斯摩尔差距范围有助于正确的诊断和管理.
相关概念视频
Diagnosing Acidosis and Alkalosis
174
Diagnosing acid-base imbalances involves systematically analyzing arterial blood samples, focusing on three key measurements: pH, bicarbonate (HCO3−) concentration, and carbon dioxide partial pressure (PCO2). This analysis follows a four-step process that helps identify the imbalance's underlying cause and nature.
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2 and...
First, the pH level is assessed to determine whether the blood pH is normal (7.35–7.45), low (acidosis), or high (alkalosis).
Next, the PCO2 and...
174
Glucose Transporters
22.6K
Glucose transporters facilitate the transport of glucose across the cell membrane. In addition to glucose, some glucose transporters can also aid the movement of other hexoses such as fructose, mannose, and galactose.
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
22.6K
Disorders of Acid-Base Balance
162
The human body maintains a precise pH range of arterial blood between 7.35 and 7.45. Deviations result in either acidosis (pH < 7.35) or alkalosis (pH > 7.45). These conditions are further classified as respiratory or metabolic disorders based on their underlying cause.
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
Respiratory Acidosis and Alkalosis
Respiratory acidosis occurs due to an increase in the partial pressure of carbon dioxide PCO2 in the blood. It often arises from shallow breathing or impaired gas exchange caused by...
162
Osmosis and Osmotic Pressure of Solutions
39.5K
A number of natural and synthetic materials exhibit selective permeation, meaning that only molecules or ions of a certain size, shape, polarity, charge, and so forth, are capable of passing through (permeating) the material. Biological cell membranes provide elegant examples of selective permeation in nature, while dialysis tubing used to remove metabolic wastes from blood is a more simplistic technological example. Regardless of how they may be fabricated, these materials are generally...
39.5K
Freezing Point Depression and Boiling Point Elevation
34.5K
Boiling Point Elevation
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...
34.5K
Regulation of Water Intake
486
Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
486


