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[原发性胆汁性肝硬化中的远端肾小管性酸中毒]

[Distal renal tubular acidosis in primary biliary cirrhosis].

作者信息

Tesar V, Petrtýl J, Kalousová M, Vyhnálek P, Srnský V, Marecek Z, Brodanová M

机构信息

I. interní katedra I. lékarské fakulty Univerzity Karlovy, Praha.

出版信息

Cas Lek Cesk. 1990 Jun 22;129(25):787-91.

PMID:2393887
Abstract

5 patients with primary biliary cirrhosis (PBC), 9 patients with compensated hepatic cirrhosis of different etiology and 12 control persons were tested for renal acidification after peroral CaCl2 administration and urine Na2SO4 and pCO2 infusion as well as the gradient between partial urine pressure and blood pressure after NaHCO3 application. Distal renal tubular acidosis (DRTA) was diagnosed in one patient with PBC, latent DRTA in other 2 patients with PBC. Not even one patient's acidification disorder was eliminated through an increased sodium application to the acidification site after Na2SO4 application. After NaHCO3 application, the gradient between the CO2 partial pressure in the urine and blood in both patients with PBC was, however, latent, DRTA normal. After pH gradient elimination in patients with PBC and DRTA, the hydrogen iont secretion is thus comparable with the control persons. Based on this study, the authors believe that the gradient type of DRTA is characteristic of primary biliary cirrhosis.

摘要

对5例原发性胆汁性肝硬化(PBC)患者、9例不同病因的代偿期肝硬化患者和12名对照者进行了口服氯化钙后肾脏酸化功能测试,以及尿液硫酸钠和二氧化碳输注后的测试,同时还测试了应用碳酸氢钠后尿分压与血压之间的梯度。1例PBC患者被诊断为远端肾小管酸中毒(DRTA),另外2例PBC患者为潜在性DRTA。在应用硫酸钠后,即使增加酸化部位的钠摄入量,也没有消除任何患者的酸化障碍。然而,在应用碳酸氢钠后,2例PBC患者尿液中二氧化碳分压与血液中二氧化碳分压之间的梯度正常,为潜在性DRTA。在PBC和DRTA患者中消除pH梯度后,氢离子分泌与对照者相当。基于这项研究,作者认为DRTA的梯度类型是原发性胆汁性肝硬化的特征。

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