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缺血后的肾脏酸碱代谢

Renal acid-base metabolism after ischemia.

作者信息

Holloway J C, Phifer T, Henderson R, Welbourne T C

出版信息

Kidney Int. 1986 May;29(5):989-94. doi: 10.1038/ki.1986.98.

Abstract

The response of the kidney to ischemia-induced cellular acidosis was followed over the immediate one hr post-ischemia reflow period. Clearance and extraction experiments as well as measurement of cortical intracellular pH (pHi) were performed on Inactin-anesthetized Sprague-Dawley rats. Arteriovenous concentration differences and para-aminohippurate extraction were obtained by cannulating the left renal vein. Base production was monitored as bicarbonate released into the renal vein and urine; net base production was related to the renal handling of glutamine and ammonia as well as to renal oxygen consumption and pHi. After a 15 min control period, the left renal artery was snared for one-half hr followed by release and four consecutive 15 min reflow periods. During the control period, cortical cell pHi measured by [14C]-5,5-Dimethyl-2,4-Oxazolidinedione distribution was 7.07 +/- 0.08, and Q-O2 was 14.1 +/- 2.2 micromoles/min; neither net glutamine utilization nor net bicarbonate generation occurred. After 30 min of ischemia, renal tissue pH fell to 6.6 +/- 0.15. However, within 45 min of reflow, cortical cell pH returned and exceeded the control value, 7.33 +/- 0.06 vs. 7.15 +/- 0.08. This increase in pHi was associated with a significant rise in cellular metabolic rate, Q-O2 increased to 20.3 +/- 6.4 micromoles/min. Corresponding with cellular alkalosis was a net production of bicarbonate and a net ammonia uptake and glutamine release; urinary acidification was abolished. These results are consistent with a nonexcretory renal metabolic base generating mechanism governing cellular acid base homeostasis following ischemia.

摘要

在缺血再灌注后的即刻1小时内,观察了肾脏对缺血诱导的细胞酸中毒的反应。对用安泰酮麻醉的Sprague-Dawley大鼠进行了清除率和摄取实验以及皮质细胞内pH(pHi)的测量。通过插管左肾静脉获得动静脉浓度差和对氨基马尿酸摄取量。监测碱生成情况,即释放到肾静脉和尿液中的碳酸氢盐;净碱生成与肾脏对谷氨酰胺和氨的处理以及肾脏耗氧量和pHi有关。在15分钟的对照期后,将左肾动脉夹闭半小时,然后松开并进行连续四个15分钟的再灌注期。在对照期,通过[14C]-5,5-二甲基-2,4-恶唑烷二酮分布测量的皮质细胞pHi为7.07±0.08,Q-O2为14.1±2.2微摩尔/分钟;既没有净谷氨酰胺利用也没有净碳酸氢盐生成。缺血30分钟后,肾组织pH降至6.6±0.15。然而,在再灌注45分钟内,皮质细胞pH恢复并超过对照值,分别为7.33±0.06和7.15±0.08。pHi的这种升高与细胞代谢率的显著升高相关,Q-O2增加到20.3±6.4微摩尔/分钟。与细胞碱中毒相应的是碳酸氢盐的净生成以及氨的净摄取和谷氨酰胺的释放;尿液酸化被消除。这些结果与一种非排泄性肾脏代谢碱生成机制一致,该机制在缺血后控制细胞酸碱平衡。

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