Häussinger D
Medizinische Universitätsklinik, University of Freiburg.
Z Gastroenterol. 1992 Feb;30(2):147-50.
Traditionally, lungs and kidneys are viewed as principal organs being involved in systemic acid-base homeostasis in mammals, but this view is not entirely compatible with basic principles of chemistry [for reviews see (1-3)]. Accordingly, a new acidbase concept was developed including an important role of the liver. Hepatic urea synthesis is an energy-driven, irreversible neutralization of the strong base HCO3- by the weak acid NH4+ and a potent feed-back regulation circuit adjusts urea cycle flux, i.e. irreversible hepatic HCO3- elimination, to the requirements of the acid base situation. Accordingly, the liver becomes a major organ for maintenance of HCO3- homeostasis and several implications for clinical medicine are derived from this "new" liver function.
传统上，肺和肾被视为参与哺乳动物全身酸碱平衡的主要器官，但这种观点并不完全符合化学基本原理[综述见(1 - 3)]。因此，一个新的酸碱概念应运而生，其中肝脏起着重要作用。肝脏尿素合成是由能量驱动的、弱酸NH4+对强碱HCO3-的不可逆中和过程，一个有效的反馈调节回路可根据酸碱状况的需求调节尿素循环通量，即肝脏对HCO3-的不可逆清除。因此，肝脏成为维持HCO3-平衡的主要器官，这一“新”肝功能对临床医学有诸多启示。
