混合酸碱干扰：核心课程2025。

IF 8.2 1区医学 Q1 UROLOGY & NEPHROLOGY

American Journal of Kidney Diseases Pub Date : 2025-07-29 DOI:10.1053/j.ajkd.2025.04.014

Biff F. Palmer , Deborah J. Clegg

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引用次数: 0

摘要

混合酸碱失调在临床实践中经常遇到，由于其复杂性，诊断和治疗具有挑战性。多重干扰的相反作用可导致血液pH值接近正常，或单独的酸碱干扰可产生叠加效应，导致血液和细胞内pH值发生更显著的变化。对患者病史、体格检查和实验室结果(包括酸碱平衡、阴离子间隙、电解质、通过分析代偿机制的适宜性、评估血清和尿液电解质的变化以及估计尿酸排泄，尿液参数（urine parameters）能够快速诊断混合性酸碱失调。提供了八个例子来说明这种方法对混合酸碱扰动的影响。示例包括混合代谢和呼吸酸碱紊乱、混合呼吸酸碱紊乱和混合代谢酸碱紊乱。

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Mixed Acid-Base Disturbances: Core Curriculum 2025

Mixed acid-base disorders are frequently encountered in clinical practice and due to their complexity, diagnoses and treatment are challenging. The opposing effects of multiple disturbances can lead to blood pH levels that are near normal or separate acid-base disturbances can have an additive effect leading to more significant changes in blood and intracellular pH. A systematic evaluation of patient history, physical examination, and laboratory results (including acid-base balance, anion gap, electrolytes, and urine parameters) enables the rapid diagnosis of mixed acid-base disorders by analyzing the appropriateness of compensatory mechanisms, assessing changes in serum and urine electrolytes, and estimating urinary acid excretion. Eight cases are provided to illustrate the approach to mixed acid-base disturbances. Examples include mixed metabolic and respiratory acid-base disorders, mixed respiratory acid-base disorders, and mixed metabolic acid-base disorders.

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来源期刊

American Journal of Kidney Diseases 医学-泌尿学与肾脏学

CiteScore

20.40

自引率

2.30%

发文量

732

审稿时长

3-8 weeks

期刊介绍： The American Journal of Kidney Diseases (AJKD), the National Kidney Foundation's official journal, is globally recognized for its leadership in clinical nephrology content. Monthly, AJKD publishes original investigations on kidney diseases, hypertension, dialysis therapies, and kidney transplantation. Rigorous peer-review, statistical scrutiny, and a structured format characterize the publication process. Each issue includes case reports unveiling new diseases and potential therapeutic strategies.