DuBose T D, Pucacco L R, Seldin D W, Carter N W, Kokko J P
Kidney Int. 1979 Jun;15(6):624-9. doi: 10.1038/ki.1979.82.
Previous micropuncture studies supporting hydrogen secretion as the mechanism of bicarbonate reabsorption have relied on the demonstration of an acid disequilibrium pH in the proximal tubule after systemic administration of a carbonic anhydrase inhibitor. Previous calculations of disequilibrium pH, however, have involved the necessary assumption that PCO2 in the proximal convoluted tubule was equal to arterial blood PCO2. This assumption can no longer be supported in view of the recent demonstration that the PCO2 in proximal and distal tubular fluid exceeded arterial blood by approximately 25 mm Hg. The purpose of the present study was to determine directly pH and PCO2 with microelectrodes in both the early and late segments of the accessible proximal tubule of nine Sprague-Dawley rats before and after administration of benzolamide (2.0 mg/kg/hr, i.v.). In the early proximal tubule, pH decreased significantly after benzolamide administration from 6.98 +/- 0.03 to 6.62 +/- 0.03 pH U (P less than 0.001), and PCO2 also decreased from 65.1 +/- 1.2 to 59.3 +/- 1.4 mm Hg (P less than 0.005). In the late proximal convoluted tubule, pH did not change after benzolamide (6.75 +/- 0.02 to 6.77 +/- 0.02), but PCO2 decreased significantly (64.3 +/- 1.5 to 57.7 +/- 1.6) (P less than 0.01). We conclude: (1) the fall in both pH and PCO2 in the early proximal tubule indicates that carbonic acid, not carbon dioxide accumulates after inhibition of luminal carbonic anhydrase; (2) although PCO2 also decreased in the late proximal tubule, unlike the early segment, pH was unchanged after benzolamide administration, perhaps as a result of increased bicarbonate delivery; and (3) PCO2 in vivo was significantly greater than was systemic arterial PCO2 before and after benzolamide administration in both the early and late proximal convoluted tubule. These findings lend support to the view that bicarbonate reabsorption in the proximal convoluted tubule occurs, in part, by hydrogen secretion.
以往支持氢分泌作为碳酸氢盐重吸收机制的微穿刺研究,依赖于在全身给予碳酸酐酶抑制剂后近端小管中酸失衡pH值的证明。然而,以往对失衡pH值的计算涉及一个必要的假设,即近端曲小管中的PCO2等于动脉血PCO2。鉴于最近的研究表明近端和远端小管液中的PCO2比动脉血高出约25 mmHg,这一假设不再成立。本研究的目的是在9只Sprague-Dawley大鼠静脉注射苯磺酰胺(2.0 mg/kg/hr)前后,用微电极直接测定可及近端小管早期和晚期节段的pH值和PCO2。在近端小管早期,苯磺酰胺给药后pH值从6.98±0.03显著降至6.62±0.03 pH U(P<0.001),PCO2也从6665.1±1.2降至59.3±1.4 mmHg(P<0.005)。在近端曲小管晚期,苯磺酰胺给药后pH值未改变(6.75±0.02至6.77±0.02),但PCO2显著降低(64.3±1.5至57.7±1.6)(P<0.01)。我们得出以下结论:(1)近端小管早期pH值和PCO2的下降表明,管腔碳酸酐酶受抑制后,积累的是碳酸而非二氧化碳;(2)尽管近端小管晚期PCO2也下降,但与早期节段不同,苯磺酰胺给药后pH值未改变,这可能是由于碳酸氢盐输送增加所致;(3)在近端曲小管早期和晚期,苯磺酰胺给药前后体内PCO2均显著高于全身动脉PCO2。这些发现支持了近端曲小管中碳酸氢盐重吸收部分是通过氢分泌发生的观点。