血乳酸与ag值测定对肺心病复合型酸碱紊乱的诊断价值

departmentofrespiratorydisease，firstaffliatedhospital，shanximedicaluniversity，taiyuan030001.

【abstract】objectivetoinvestigatethevalueofserumlactate（l）andagindiagnosingmixedacid-basedisordersincorpulmonale.methodsthebloodgas，serumelectrolytesandserumlactatein112casesofcorpulˉmonaleweremeasuredsimultaneouslyandstudiedcontrastively.resultsin5acid-basedisordergroups，serumlacˉtatewasobviouslyhigherintabdandcombinedrespiratoryandmetabolicacidosisgroupthaninother3groups（p<0.01），butnoevidentdifferenceexistedamongtheother3groups（p>0.05）.therewere5caseswhohadobviouslyhigherserumlactatebutnormalag.conclusionbothagandlhavetheiradvantagesrespectivelyindiagnosingmetabolicacidosis，buttheywerenotincreasedunanimously.tothosewhowerecriticallyillwithcorpulmonale，serumlactateandagshouldbemeasuredsimulatneouslysothatthecombinedacid-basedisorderscouldbediagnosedpromptly.

keywordscorpulmonaleacid-basedisordersaniongaplactate

慢性肺心病急性加重期常并发多种类型的酸碱紊乱，及时、准确判断这些酸碱紊乱对于临床估计预后，指导治疗具有重要意义。目前临床上常根据酸碱失衡预计代偿公式和血浆阴离子间隙（ag）来判断复合型酸碱紊乱。然而，由于电解质测定所受干扰因素很多，直接影响着ag值的准确性［1］。因此，寻找诊断代酸的有效方法非常重要。本文通过对112例慢性肺心病患者血乳酸含量和ag值测定结果进行对比研究，希望能提供一个比较可靠的生化指标，以助于慢性肺心病复合型酸碱失衡的诊断。