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长期缺氧时高碳酸血症的肾脏代偿

Renal compensation of hypercapnia in prolonged hypoxia.

作者信息

Widener G, Sullivan L P, Clancy R L, Gonzalez N C

出版信息

Respir Physiol. 1986 Sep;65(3):341-50. doi: 10.1016/0034-5687(86)90018-6.

Abstract

We previously showed that rats made hypoxic for three weeks were able to regulate their plasma pH better than normoxic rats during acute hypercapnia. This improved pH regulation was abolished by nephrectomy, suggesting that it was due, at least in part, to a more effective renal compensation of hypercapnia in hypoxic rats. To test this possibility renal acid excretion was measured in conscious rats that had been kept at PB 370-380 Torr for three weeks. The rats were studied in a chamber where PIO2 was kept at 68-70 Torr at ambient PB (740-750 Torr). Controls were pair-fed normoxic rats. After a 2 h control period, inspired PCO2 was increased for 4 h. The apparent non-bicarbonate buffer value of arterial blood plasma was twice as high in the hypoxic than in the normoxic rats. Renal excretion of ammonium increased to a similar extent during hypercapnia in both normoxic and hypoxic rats. Titratable acid excretion of normoxic rats did not change significantly during hypercapnia. In the hypoxic rats, on the other hand, total excretion of titratable acid in the 2 h control period was 90.9 +/- 16.4 mumol/rat; and increased to 150.0 +/- 13.4 mumol/rat in the first 2 h and to 232.9 +/- 26.0 mumol/rat in the last 2 h of hypercapnia. In spite of this large increase in acid excretion, urine pH of hypoxic rats did not change significantly, indicating a higher buffer value of the urine of hypoxic rats. These results confirm our previous observations and support the idea that the improved pH regulation of hypoxic rats is due in part to a more effective renal compensation of hypercapnia.

摘要

我们之前发现,缺氧三周的大鼠在急性高碳酸血症期间比常氧大鼠能更好地调节其血浆pH值。肾切除可消除这种改善的pH调节,这表明其至少部分归因于缺氧大鼠对高碳酸血症更有效的肾脏代偿。为了验证这种可能性,我们测量了在370 - 380 Torr的气压下饲养三周的清醒大鼠的肾脏酸排泄。这些大鼠在一个舱室中进行研究,舱室内的PIO2在环境气压(740 - 750 Torr)下保持在68 - 70 Torr。对照组为配对饲养的常氧大鼠。在2小时的对照期后,吸入的PCO2增加4小时。缺氧大鼠动脉血浆的表观非碳酸氢盐缓冲值是常氧大鼠的两倍。在高碳酸血症期间,常氧和缺氧大鼠的铵肾排泄均有相似程度的增加。常氧大鼠在高碳酸血症期间可滴定酸排泄无显著变化。另一方面,在缺氧大鼠中,2小时对照期内可滴定酸的总排泄量为90.9±16.4 μmol/大鼠;在高碳酸血症的前2小时增加到150.0±13.4 μmol/大鼠,在最后2小时增加到232.9±26.0 μmol/大鼠。尽管酸排泄大幅增加,但缺氧大鼠的尿液pH值无显著变化,这表明缺氧大鼠尿液的缓冲值更高。这些结果证实了我们之前的观察,并支持缺氧大鼠改善的pH调节部分归因于对高碳酸血症更有效的肾脏代偿这一观点。

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