Stinebaugh B J, Schloeder F X, Gharafry E, Suki W N, Goldstein M B, Halperin M L
J Lab Clin Med. 1977 May;89(5):946-58.
Currently, the ability to elevate the urine PCO2 above that of the arterial blood is employed as an estimate of distal hydrogen ion secretion. Therefore, it is important to establish the mechanisms by which various factors affect the urine CO2 tension. This paper examines the physiologic process by which phosphate elevates the urine PCO2 in the dog. The rise in urine PCO2 due to phosphate could be the result of either (1) a distal mechanism, by affecting the delayed dehydration of carbonic acid, or (2) an increase in the medullary PCO2. The phosphate-induced elevation of urine PCO2 was abolished by carbonic anhydrase infusion. This indicates that a distal mechanism is a major factor in the phosphate effect. Since acid phosphate infusion did not result in an elevated urine PCO2, it is unlikely that changes in the medullary PCO2 occur as a ry an increase in net acid excretion, indicating an increase in hydrogen ion secretion. The increased hydrogen ion secretion and rise in urine PCO2 were reproduced by infusion of the buffer, Tris-(hydroxymethyl)-aminomethane, but not by sodium sulfate administration. These findings suggest that the phosphate-induced rise in urine PCO2 is due to the buffer properties of phosphate rather than to its nonreabsorable anion characteristics.
目前,将尿PCO₂提升至高于动脉血PCO₂的能力被用作评估远端氢离子分泌的指标。因此,明确各种因素影响尿CO₂张力的机制很重要。本文研究了磷酸盐使犬尿PCO₂升高的生理过程。磷酸盐导致的尿PCO₂升高可能是以下两种情况之一的结果:(1)一种远端机制,通过影响碳酸的延迟脱水;或者(2)髓质PCO₂升高。碳酸酐酶输注可消除磷酸盐诱导的尿PCO₂升高。这表明远端机制是磷酸盐作用的主要因素。由于输注酸性磷酸盐并未导致尿PCO₂升高,因此髓质PCO₂的变化不太可能是净酸排泄增加的结果,这表明氢离子分泌增加。输注缓冲剂三(羟甲基)氨基甲烷可重现氢离子分泌增加和尿PCO₂升高的情况,但输注硫酸钠则不能。这些发现表明,磷酸盐诱导的尿PCO₂升高是由于磷酸盐的缓冲特性,而非其不可重吸收的阴离子特性。