摘要目的 比较Hamm及周寿生2组酸碱失衡预计代偿范围计算公式的差别及其合理性.方法 将745份实测异常血气分析结果同时用2组公式判断其酸碱失衡类型,用Kappa检验2组公式的一致性.结果 两组公式判断108份代谢性酸中毒一致率为70.4%(Kappa值0.41,P＜0.01);判断132份代谢性碱中毒一致率为59.1%(Kappa值0.18,P＜0.05);判断81份急性呼吸性酸中毒一致率为65.4%(Kappa值0.31,P＜0.01);判断168份急性呼吸性碱中毒一致率为54.8%(Kappa值0.24,P＜0.01):判断119份慢性呼吸性酸中毒一致率为67.2%(Kappa值0.41,P＜0.01);判断137份慢性呼吸性碱中毒一致率为66.6%(Kappa值0.43,P＜0.01).结论 用Hamm和周寿生2组公式判断酸碱失衡类型存在明显差别,周寿生公式组转化后,其继发变化的最大预计代偿系数略高于其原始采纳的代偿系数.

abstractsObjective To compare the difference and rationalities between Harmm and Zhou' s formulae for expected acid-base compensation in acid-base imbalance. Methods 745 cases of arterial blood gas analysis results of acid-base disorder were evaluated respectively by Hamm and Zhou' s formulae, and the concordance was judged. Results For metabolic acidosis ( 108 cases), the concordance rate was 70. 4% between Hamm and Zhou's( Kappa value =0. 41 ,P ＜0. 01 ) ;for metabolic alkalosis ( 132 cases) ,the concordance rate was 59. 1% ( Kappa value =0. 18 ,P ＜0. 05) ;for acute respiratory acidosis(81 cases) ,the concordance rate was 65.43% ( Kappa value = 0. 31, P ＜ 0. 01 ) ;for acute respiratory alkalosis ( 168 cases), the concordance rate was 54. 8% ( Kappa value = 0. 24%, P ＜ 0. 01 ); for chronic respiratory acidosis ( 119 cases ), the concordance rate was 67.2% ( Kappa value = 0. 41, P ＜ 0. 01 ) ;for chronic respiratory alkalosis( 137 cases), the concordance rate was 66. 6% ( Kappa value = 0. 43, P ＜ 0. 01 ). Conclusion The difference between Hamm and Zhou' s formulae for expected acid-base compensation in acid-base imbalance was obvious. The Zhou' s expected max compensation coefficient were slightly higher than the primary adopted compensation coefficient.