目的 评估糖尿病酮症酸中毒(DKA)和终末期糖尿病肾脏疾病(DKD)患者外周静脉血与动脉血pH值、HCO3-浓度的相关性.方法 对40例DKA患者和40例终末期DKD患者的动、静脉血标本行血气分析,比较其血pH值及HCO3-浓度并进行相关性分析.结果 DKA患者的动脉血pH和HCO3-分别为(7.09±0.13)和(7.76±3.03)mmol/L,静脉血pH和HCO3-分别为(7.05±0.14)和(9.63±2.90) mmol/L,动、静脉血pH值和HCO3-差值分别为(0.04±0.03)和(-1.87 ±0.36)mmoL/L.终末期DKD患者的动脉血pH和HCO3-分别为(7.11±0.10)和(8.20±2.75) mmol/L,静脉血pH和HCO;分别为(7.07 0.11)和(10.00±2.65) mmol/L,动、静脉血pH和HCO3-差值分别为(0.04 ±0.02)和(-1.80 ±0.40)mmoVL.DKA患者动静血pH值和HCO3-浓度(r=0.987和r=0.994,P＜0.001)及终末期DKD患者动静血pH值和HCO3-浓度(r=0.982和r=0.989,P ＜0.001)均呈高度相关.结论 外周静脉血气可以用于评价DKA及终末期DKD患者的酸碱状态.%Objective To assess correlation between venous and arterial pH values as well as HCO3-concentrations in acidotic patients with diabetic ketoacidosis(DKA) and end-stage diabetic kidney disease(DKD).Methods Arterial and venous blood samples from DKA patients (40 cases) and end-stage DKD patients(40 cases) were analyzed for measurements of blood gas and acid-base status.Results In DKA patients,Arterial pH and HCO3-were(7.09 ±0.13) and (7.76 ± 3.03) mmol/L while venous pH and HCO3-were (7.05 ± 0.14) and (9.63 ± 2.90)mmol/L.The differences between arterial and venouspH and HCO3-were (0.04 ±0.03) and (-1 87 ± 0.36) mmol/L.In end-stage DKD patients,Arterial pH and HCO3-were(7.11 ±0.10) and (8.20 ± 2.75)mmol/L while venous pH and HCO3-were (7.07 ± 0.11) and (10.00 ± 2.65) mmol/L.The differences between arterial and venous pH and HCO3-were (0.04 ± 0.02) and (-1.80 ± 0.40) mmol/L.Arterial and venous pH and HCO3-were highly correlated both in DKA group (r =0.987 and r =0.994 respectively,P ＜ 0.001) and end-stage DKD group (r =0.982 and r =0.989 respectively,P ＜ 0.001).Conclusion Gas analysis of venous blood sample can be used to evaluate the acid-base status in DKA and DKD patients.
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