糖尿病酮症酸中毒患者脑脊液酸碱失衡及其代偿机制
糖尿病酮症酸中毒,,;脑脊髓液;酸碱失调;代偿机制,0引言,1对象和方法,2结果,3讨论,【参考文献】
(第四军医大学唐都医院呼吸内科,陕西 西安 710038, 第三军医大学新桥医院呼吸病研究所, 解放军68351部队门诊)Study of CSF acidbase disorders and compensatory mechanism in patients with diabetic ketoacidosis
JIN FaGuang, QIAN GuiSheng, ZHAO ZiQiang, LIU TongGang, DANG YongJin
Department of Respiratory Disease, Tangdu Hospital, Fourth Military Medical University, Xian 710038, China, Institute of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Clinic of Chinese PLA Unit 68351
【Abstract】AIM: To investigate cerebrospinal fluid (CSF) acidbase disorders and its compensatory mechanism in patients with diabetic ketoacidosis. METHODS: Arterial blood and CSF samples from 15 patients with diabetic ketoacidosis were collected and analyzed. RESULTS: ① Although metabolic acidosis occurred in CSF as in arterial blood, CSF pH, PCO2 and HCO3- were lower than those in the control (P<0.01); ② CSF pH, PCO2, HCO3- were higher than those in the arterial blood in patients with ketoacidosis (P<0.01) and there was a significant positive correlation between CSF and the arterial blood; ③ Ketone bodies of CSF were higher than those in the control (P<001) but were lower than those in the arterial blood (P<001) and there was a significant positive correlation between CSF and the arterial blood; ④ There was a significant positive correlation between CSF HCO3- and CSF PCO2 but there was a negative correlation between CSF HCO3- and CSF ketone bodies; ⑤ There was a significant positive correlation between CSFpH and CSF HCO3- but there was an negative correlation between CSF pH and CSF ketone bodies. CONCLUSION: Although metabolic acidosis occurred in CSF as in arterial blood, the normal range of CSF pH can be maintained for the reason that the barrier of bloodbrain and bloodCSF inhibits blood ketone bodies from entering CSF and the compensation ability of CSF PCO2 is higher than that of arterial blood. In case blood ketone bodies increase markedly, PaCO2 will decrease significantly, thus leading to sever metabolic acidosis in CSF. ......
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