强离子隙等三项酸碱失衡诊断指标在肾性低蛋白血症中的应用比较  

A comparison of strong ion gap three diadynamic criteria of acid-Base derangements in the nephritic hypoalbuminemia

作　　者：张忠源[1] 叶桂云[1] 胡望平[1] 池细弟[1] 吴志耘[1] 李智海[1] 张永平[1] 

机构地区：[1]南平市第一医院.福建医科大学南平教学基地检验科,福建南平353000

出　　处：《中国实验诊断学》2009年第4期523-525,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的继pH、阴离子隙(AG)后的第三代方程式产生的强离子隙(SIG)的应用,探讨其在肾性低蛋白血症中的临床意义。方法在测定血气、血pH、电解质结果基础上,应用Stewart-Figge方法学的方程式计算SIG。结果(1)比较了SIG、AG及潜在HCO3-等三种诊断指标,以SIG与AG的相关性最好:r=0.967 3。(2)比较肾病患者三种指标,以SIG异常率最高(90.5%);上升幅度最大,是参考值的3.67倍。(3)比较低白蛋白血症肾病与非肾病二组,以SIG的二组差异率最大,为7.42倍,P<0.001。AG及潜在HCO3-次之。结论三种诊断指标以SIG灵敏度最高,若呼吸功能衰竭的酸碱失衡需要潜在HCO3-;而肾功能衰竭的酸碱失衡更需要SIG。Objective Application of thirdly equation-strong ion gap （SIG） that to continue pH, the anion gap （AG） generated, approach clinical significance for SIG on nephritic hypoalbuminemia.Methods SIG is calculated with The Stewart-Figge model,after determination of blood gas, blood pH, serum electrolytes. Results （ 1 ）Comparison on A G, potential bicarbonate and SIG, et al Three Diadynamic Criteria,the dependablity to be found SIG to agree well with AG： r = 0.967 3. （2）Comparison on Three Diadynamic Criteria, abnonnity rate of SIG is best high （90.5 % ） ; up grade argument is best high, ratio reference value upper limit is 3.67 times. （3） Comparison of nephropathia and non-nephropathia in Hypoalbuminemia, SIG difference rate is greatest, 7.42 times, P 〈 0.001. secondary is AG and potential bicarbonate. Conclusion SIG sensibility is best high in three acid-base imbalance diadynamic criteria, respiratory non-function request to potential bicarbonate,renal failure furthermore request to SIG.

关 键 词：强离子隙 阴离子隙 低白蛋白血症 肾功能衰竭 潜在HCO3- 

分 类 号：R692[医药卫生—泌尿科学]