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影响犬肾小管碳酸氢盐重吸收的因素。

Factors modifying renal tubular bicarbonate reabsorption in the dog.

作者信息

Ullmann E

出版信息

J Physiol. 1968 Feb;194(3):573-94. doi: 10.1113/jphysiol.1968.sp008426.

DOI:10.1113/jphysiol.1968.sp008426
PMID:5636989
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1365654/
Abstract
  1. Acute experiments were carried out on anaesthetized dogs during metabolic alkalosis produced by I.V. administration of NaHCO(3). Partial constriction of one ureter led to a significant rise in the HCO(3) (-) threshold, beyond the simultaneous value for the other kidney. The magnitude of the increase was not correlated with the reduction of glomerular filtration.2. Stop-flow analysis, following complete unilateral obstruction of urine flow, demonstrated proximal as well as distal tubular reabsorption of bicarbonate. At any given plasma P(co2) the detailed configuration of the concentration changes which developed depended on (a) the presence and concentration of mannitol, (b) the duration of urinary stasis, and (c) the plasma concentration of HCO(3) (-).3. If a solution containing 15% (w/v) mannitol was infused I.V., the HCO(3) (-) concentration in free flow urine was lower than in plasma, and it fell further during arrest of flow in the entire column of trapped fluid. If less mannitol was infused, or none at all, interruption of urine flow led to a striking increase of HCO(3) (-) concentration in the distal portion of the occluded column, and to a fall in the fluid arrested in the proximal segments.4. It was demonstrated that the HCO(3) (-) concentration attained after 2(1/2), 6, or 15 min of urinary stasis at any point in the trapped fluid column was due to the combined effects of water reabsorption and HCO(3) (-) reabsorption which proceeded independently, and with a different time course.5. If mannitol was administered the lowest urinary HCO(3) (-) concentration in the series moved progressively to a more distal location with increasing duration of urinary stasis. When HCO(3) (-) concentration peaks were present in distal fluid they were conspicuous only after short interruptions of urine flow; during extended stop-flow periods they became attenuated, or disappeared. If no mannitol was administered this did not occur.6. Provided the plasma level of HCO(3) (-) was sufficiently elevated, mannitol (15%, w/v) was administered, and the time available for reabsorption was lengthened by ureter obstruction, much larger concentration differences between plasma and trapped fluid developed than the largest that are ever found between the plasma and freely draining urine. The magnitude of the largest plasma-urine (P-U) concentration difference for HCO(3) (-) increased with intratubular ;contact time', and no limiting value was found.7. Potassium concentration in distal occluded fluid fell with prolonged duration of stasis. This was related to the slow and progressive diminution of distal HCO(3) (-) concentration. But if instead of bicarbonate a nonreabsorbable anion, such as phosphate, was the dominant distal anion, K(+) concentration in distal fractions remained high and rose further with time.
摘要
  1. 对静脉注射碳酸氢钠诱发代谢性碱中毒的麻醉犬进行急性实验。一侧输尿管部分狭窄导致碳酸氢根阈值显著升高,高于另一侧肾脏同时刻的值。升高幅度与肾小球滤过率降低无关。

  2. 在完全单侧尿路梗阻后进行停流分析,结果表明近端和远端肾小管均有碳酸氢根重吸收。在任何给定的血浆二氧化碳分压下,所出现的浓度变化的详细形态取决于:(a)甘露醇的存在及其浓度;(b)尿液潴留的持续时间;(c)血浆碳酸氢根浓度。

  3. 如果静脉输注含15%(重量/体积)甘露醇的溶液,自由流动尿液中的碳酸氢根浓度低于血浆中的浓度,且在整个截留液柱停止流动期间进一步下降。如果输注的甘露醇较少或根本不输注,尿液流动中断会导致梗阻柱远端部分的碳酸氢根浓度显著升高,而近端段截留液中的碳酸氢根浓度下降。

  4. 结果表明,在截留液柱的任何位置,尿液潴留2.5、6或15分钟后达到的碳酸氢根浓度是水重吸收和碳酸氢根重吸收共同作用的结果,二者独立进行,且时间进程不同。

  5. 如果给予甘露醇,随着尿液潴留时间延长,该系列中最低的尿液碳酸氢根浓度逐渐向更远处移动。当远端液中出现碳酸氢根浓度峰值时,仅在尿液短暂中断后才明显;在长时间停流期间,它们会减弱或消失。如果不给予甘露醇,则不会出现这种情况。

  6. 只要血浆碳酸氢根水平充分升高,给予甘露醇(15%,重量/体积),且通过输尿管梗阻延长重吸收时间,血浆与截留液之间形成的浓度差会比血浆与自由引流尿液之间发现的最大浓度差大得多。碳酸氢根的最大血浆-尿液(P-U)浓度差的大小随肾小管内“接触时间”增加而增大,未发现极限值。

  7. 远端梗阻液中的钾浓度随潴留时间延长而降低。这与远端碳酸氢根浓度缓慢且逐渐降低有关。但如果远端主要阴离子不是碳酸氢根而是不可重吸收的阴离子,如磷酸根,则远端部分的钾离子浓度仍会很高,并随时间进一步升高。

相似文献

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本文引用的文献

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Urine acidity in alcohol diuresis in man.人体酒精利尿时的尿液酸度
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