In HHS, you can sometimes see mild ketonemia and acidosis, but not to the extent that it's seen in DKA, and in DKA you can see some hyperosmolarity, so there is definitely overlap between these two syndromes.

HHS中，有时会出现轻度酮血症和酸中毒，但不会进展到DKA那么严重；在DKA中，可看到一些高渗症状，所以上述两种综合征之间确实有部分相同症状。

In the case of health, sodium bicarbonate indeed has a solid track record largely thanks to its metabolic acidosis buffering, aiding the kidneys in acid-base balance and preventing bone mineral loss.

在康方面， 有记录显示碳酸氢钠确实有助康，这在很大程度上归功它的代谢性酸中毒的缓冲作用，帮助肾脏酸碱平衡，防止骨矿物质流失。

Now, this isn't always the case for acidosis, though, for example, in respiratory acidosis, potassium levels aren't affected because CO2 is lipid soluble and freely moves into cells without being exchanged for potassium, therefore no hyperkalemia.

但是酸中毒的情况并不都是如此，例如，在呼吸性酸中毒时，钾离子平不受影响，因为CO2是脂溶性的，可以自由进出细胞不需要钾离子做交换，因此这种情况下，不会产生高钾血症。

In 1922 at the University of Toronto, the scientists went to a hospital ward full of diabetic children, most of them comatose and dying from diabetic keto-acidosis.

1922 年，在多伦多大学，科学家们去了一间满是儿童的医院房，他们中的大多数人昏迷不醒，死酮症酸中毒。

That's called — appropriately — muscle acidosis, and the drop in pH may be part of what causes the famous burn while you're exercising.

这被称为肌肉酸中毒，并且酸碱值下降可能是运动时肌肉燃烧的部分原因。

And doctors have regularly smelled acetone on the breath of patients who are in a state of diabetic ketoacidosis and used it as a diagnostic.

而医生经常通过闻酮症酸中毒患者呼吸中的丙酮作为诊断方法。

Like low levels of bicarbonate can cause metabolic acidosis with deep and labored breathing called Kussmaul breathing.

低平的碳酸氢盐会导致代谢性酸中毒，伴随深大呼吸，称为Kussmaul呼吸。

Somewhat similarly, in diabetic ketoacidosis, there are low levels of insulin, and although the exact mechanism is unclear, it reduces the amount of phosphate that cells extract from the blood, causing it again to build up in the blood.

类似地，在酮症酸中毒中，胰岛素平较低，尽管确切机制尚不清楚，它使细胞从血液中提取的磷酸盐量降低，使磷酸盐再次在血液中积累。

Treatment of a DKA episode involves giving plenty of fluids, which helps with dehydration, insulin which helps lower blood glucose levels, and replacement of electrolytes, like potassium; all of which help to reverse the acidosis.

DKA的治疗包括大量饮以缓解脱，使用胰岛素来降低血平，以及补充电解质，如钾；这些都会缓解酸中毒。

And, even though sodium bicarbonate can buffer metabolic acidosis, an event that increases muscle breakdown, no research has shown supplementation to improve muscle growth nor preserve muscle.

而且，尽管碳酸氢钠可以缓冲会增加肌肉损伤的代谢性酸中毒，但没有研究表明补充剂可以改善肌肉生长或保护肌肉。

These ketone bodies are important because they can be used by cells for energy, but they also increase the acidity of the blood, which is why it's called keto-acid-osis.

这些酮体很重要，可被细胞用来获取能量，但他们也会增加血液酸性，所以才叫作酮症酸中毒。

So other things start to build up in the blood as well, like potassium, called hyperkalemia, as well as acids, called metabolic acidosis.

因此其他物质也开始在血液中堆积：比如钾，造成高钾血症；还有酸，引起代谢性酸中毒。

One really serious complication with type 1 diabetes is called diabetic ketoacidosis, or DKA.

1型有一种很严重的并发症，叫作酮症酸中毒，或DKA。

Similarly, when there's a metabolic acidosis from excess organic acids like lactic acid and ketoacids, protons can enter cells with the organic anion rather than having to get exchanged for potassium ions.

相同地，当有机酸如乳酸和酮酸过多，产生代谢性酸中毒时，质子会和有机阴离子一起进入细胞，而不是同钾离子交换。

So in order to help compensate for an acidosis, hydrogen ions enter cells and potassium ions leave the cells and enter the blood, which might help with the acidosis, but results in hyperkalemia.

所以为了代偿酸中毒，氢离子被移入细胞内，而钾离子被移出细胞而进入血中，这一机制缓解了酸中毒，但却导致了高钾血症。

Diabetic ketoacidosis can happen even in people who've already been diagnosed with diabetes and currently have some sort of insulin therapy.

已被诊断出并开始接受胰岛素治疗的患者也会产生酮症酸中毒。

Another cause of an internal potassium balance shift could be an acidosis, which is when the blood becomes too acidic, in other words, there's a higher concentration of hydrogen ions —which means a lower blood pH.

另一个打破内钾平衡的原因是酸中毒，即血液成分过酸，换言之就是血液中氢离子浓度较高，导致血液pH值较低。

Another situation is when living cells get affected by respiratory acidosis, which is when the carbon dioxide levels rise because a person isn't breathing or ventilating it out of the lungs quickly enough.

另一种情况是活细胞受到呼吸性酸中毒的影响，即一个人由没有迅速呼吸排出CO2，导致血中CO2平上升。

We've got a diabetic ketoacidosis, let's go.

我们得了酮症酸中毒，走吧。

I've mentioned DKA a few times as a deadly consequence, but I want to walk you through what that looks like.

我多次提到酮症酸中毒作为一种致命的后果，但我想带你们了解一下它具体是什么样的。