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据报道,在未经治疗的糖尿病酮症酸中毒患者中,约22～32％血钾浓度高于6.0～6.1mmol/L。严重高血钾常常是导致糖尿病酮症酸中毒死亡的主要原因。 对血钾浓度升高的解释,一般认为是代谢性酸中毒时H~+进入细胞内置换出K~+。但近期研究对这种传统观点提出怀疑。首先是给没有糖尿病的动物静脉内注入酮酸、β-羟丁酸、乳酸、甲基丙二酸等有机酸,虽产生酸中毒,并未出现高钾血症,而注入氨化铵盐酸等无机酸,在酸血症程度相等条件下,却可产生高钾血症。此外,还有研究发现,糖尿病酮症酸中毒时,血液pH与血清钾浓度无相关性。
It has been reported that in patients with untreated diabetic ketoacidosis, about 22 to 32% potassium concentration higher than 6.0 ~ 6.1mmol / L. Serious hyperkalemia is often the leading cause of death from diabetic ketoacidosis. The explanation for the increase of serum potassium concentration is generally considered to be metabolic acidosis H ~ + into the cell replacement K ~ +. However, recent studies raise doubts about this traditional view. The first is to intravenous infusion of ketoacid, β-hydroxybutyric acid, lactic acid, methylmalonic acid and other organic acids to animals without diabetes mellitus, although there is no acidosis, hyperkalemia does not appear, while ammonia chloride hydrochloride Inorganic acid, in the same degree of acidosis, but can produce hyperkalemia. In addition, there are studies have found that diabetic ketoacidosis, the blood pH and serum potassium concentration was not related.