脑脊液高碳酸血症后碱中毒与利尿剂的应用研究

• 作 者: 金发光 钱桂生 邵丽丽 赵自强
• 机 构: 第三军医大学新桥医院全军呼吸专科中心
• 出 处: 中国病理生理杂志
• 发表日期: 1995年03期
• 关键词: 碱中毒 高碳酸血症 乙酰唑胺 脑脊髓液 呼吸性 有显著性差异 琥珀酰胆碱 精神错乱 变量值 癫痫样发作

本研究动态观察了犬急性呼吸性酸中毒动脉血和ＣＳＦ酸碱变量。动脉血酸碱变量在８ｈ实验过程中３组均无明显差异（Ｐ＞０．０５）。ＣＳＦｐＣＯ＿２的变化值同动脉血相似，但ＣＳＦ［ＨＣＯ＿３－］在３组之间有显著性差异（Ｐ＜０．０１）。Ⅰ、Ⅱ、Ⅲ组ＣＳＦ［ＨＣＯ＿３－］８ｈ分别增加了６、１．２和８ｍｍｏｌ／Ｌ。结果表明急性呼吸性酸中毒迅速纠正后，ＣＳＦ发生了代谢性碱中毒。乙酰唑胺能预防和治疗ＣＳＦ高碳酸血症后碱中毒，速尿可诱发和加重ＣＳＦ高碳酸血症后碱中毒。

This study dynamically observed arterial blood and CSF acid-base variables of acute respiratory acidosis in dogs. There was no significant difference in arterial pH between the three groups during 8h (P> 0.05). The change of CSFpCO_2 was similar to that of arterial blood, but CSF [HCO_3-] was significantly different among the three groups (P <0.01). The levels of CSF [HCO_3-] 8h in groups Ⅰ, Ⅱ and Ⅲ increased by 6, 1.2 and 8mmol / L, respectively. The results showed that after acute respiratory acidosis was corrected rapidly, CSF had a metabolic alkalosis. Acetazolamide can prevent and treat CSF hypercapnia alkalosis, furosemide can induce and aggravate alkalosis after CSF hypercapnia.