老年女性，70岁。反复咳嗽、咳痰、喘憋 30余年，加重1周。血气分析：pH 7.23, PaC02 76mmHg, Pa02 57mmHg, HC03" 28mmol/L, BE 6. 3mmol/L0该患者最可能 的酸碱平衡紊乱是

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