一个人可以使用血清乳酸度来纠正离子差距吗?
Ramin Sam1, Nancy Zhou1, Emilio Fernandez1
1Division of Nephrology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA.
Journal of intensive care medicine
|January 6, 2026
概括
患有乳酸酸症的危急病患者可能有其他的离子间隙代谢酸症的原因. 从离子间隙中减去血清乳酸可以帮助在重症监护病房患者中确定这些额外的原因.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學.
- 生物化学 生物化学
背景情况:
- 阴离子间隙代谢酸症在重症监护室 (ICU) 患者中很常见,通常是由于乳酸酸症.
- 血清乳酸盐是常规测量,但其在识别酸性疾病的其他原因的实用性是不清楚的.
研究的目的:
- 确定测量血清乳酸盐水平是否可以帮助识别危急病患者阴离子代谢酸的次要原因.
主要方法:
- 在单一机构两年内分析了503次乳酸性化 (血清乳酸>5 mmol/L) 病例.
- 血清阳离子间隙减去血清乳酸,纠正的阳离子间隙和强离子间隙的计算.
主要成果:
- 血清阳离子间隙减去血清乳酸的平均值为6.9mEq/L.
- 阴离子间隙-血清乳酸>8.0mEq/L的发作往往是由提升的白蛋白,,或β-基酸盐解释的.
- 平均纠正的离子间隙为-1.3 mEq/L,平均强离子间隙为5.1 mEq/L.
结论:
- 从血清阳离子间隙中减去血清乳酸,可以帮助确定ICU患者阳离子间隙代谢酸的其他原因.
- 当离子间隙-乳酸盐差异很高时,提升的白蛋白,,或β-基酸盐是常见的次要原因.
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