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通过对97例 EHF 患者的阴离子隙(AG)和血清 Na~+、K~+、Cl~-、HCO_3~-、白蛋白、钙含量以及内生肌酐清除率变化的同步动态监测,结合临床资料的分析,本研究发现,EHF 中 AG 升高的主要原因是未测定阴离子(UA)增多和血液浓缩。而 UA 增多主要是由于严重的急性肾功能衰竭肾小球滤过率极度下降所致的 UA 排泄减少而潴留体内所引起的,重症患者和少尿期的 AG 升高尤为如此;UA 生成过多则为 UA 增多的次要原因,由血液浓缩所致的 AG 升高只见于存活患者。本文首次提出并论证了 AG 升高对于 EHF 患者不仅提示可能有代谢性酸中毒存在,还能提示肾小球滤过率极度下降、病情严重、预后不良。
Through dynamic monitoring of the changes of anion gap (AG) and serum Na ~ +, K ~ +, Cl ~ -, HCO 3 ~, albumin, calcium and endogenous creatinine clearance in 97 EHF patients, combined with clinical data The study found that the main cause of AG elevation in EHF was the undetectable anions (UA) increase and blood concentration. The increase in UA was mainly due to a decrease in UA excretion resulting from a severe decrease in glomerular filtration rate in severe acute renal failure, especially in patients with severe and oliguric periods caused by retention of the UA; UA overproduced The main reason for the increase of UA. The increase of AG caused by blood concentration is only found in the surviving patients. This article for the first time presented and demonstrated that elevated AG in patients with EHF not only prompted the possibility of metabolic acidosis, but also prompted a significant decline in glomerular filtration rate, serious condition, poor prognosis.