Objective: To investigate the characteristics of acid-base balance in patients with chronic severe hepatitis.
Methods: Samples of venous blood and arterial blood were collected from 126 patients with chronic severe hepatitis, 106 males and 20 females, aged 44 +/- 13 (25 - 74), to undergo measurement of the potassium, sodium, and chloride ions, and urea nitrogen and creatine, blood electrolytes and blood gas analysis respectively.
Results: Acid-base disturbance (ABD) was found in 115 of the 126 patients (91.3%). 40 of the 115 patients with ABD (31.7%) had respiratory alkalosis combined with metabolic alkalosis, 32 of them (25.4%) had respiratory alkalosis combined with metabolic acidosis; 28 of them (22.2%) had pure respiratory alkalosis, and 8 (6.3%) had pure metabolic acidosis. Five patients had triple acid-base disturbance, 4 of which had respiratory alkalosis (combined with metabolic alkalosis and metabolic acidosis, 3.2%), and 1 of which had respiratory acidosis (combined with metabolic alkalosis and metabolic acidosis, 0.8%). There was no significantly difference in the prevalence rates of pure acid-base disturbance and multiple acid-base disturbances between the patients with cirrhosis-base chronic severe hepatitis and those with chronic hepatitis-based chronic severe hepatitis. Hypoxia symptoms were seen in 34 patients (27%). 103 patients died. All the 15 patients with their blood pH < 7.35 died.
Conclusion: ABD in the patients with chronic severe hepatitis is mainly alkalosis with respiratory alkalosis as the basic ABD type. The appearance of ABD is not associated with the underlying illness. Patients of chronic severe hepatitis often suffer from hypoxia. Low blood pH is an important factor causing death.