Tam S C, Goldstein M B, Stinebaugh B J, Chen C B, Gougoux A, Halperin M L
Kidney Int. 1981 Nov;20(5):636-42. doi: 10.1038/ki.1981.187.
The purpose of these studies was to clarify the basis of the relationship between the urine bicarbonate concentration and the urine minus blood PCO2 difference in alkaline urine (U-B PCO2) and hence shed light on factors that influence hydrogen ion secretion in the collecting duct in vivo. The U-B PCO2 was used to monitor this latter parameter. In dogs with a normal extracellular fluid (ECF) volume, the U-B PCO2 was not primarily influenced by the urine bicarbonate concentration but rather it was related to the rate of sodium excretion. The U-B PCO2 could be abolished by amiloride when the urine bicarbonate concentration was less than 60 mm. At higher urine bicarbonate concentrations, there was a linear correlation between the U-B PCO2 and the urine bicarbonate concentration in normovolemic dogs given amiloride, but the absolute values were lower than they were in normovolemic animals not treated with amiloride. In the dogs with an expanded ECF volume, the U-B PCO2 was lower than it was in the normovolemic animals, and the U-B PCO2 was nor directly related to the urine bicarbonate concentration and not influenced by the rate of sodium excretion. Amiloride had little influence on the U-B PCO2 under these conditions. These results are interpreted to suggest that the magnitude of collecting duct hydrogen ion secretion is determined primarily by the electrical gradient generated by sodium reabsorption in normovolemic dogs and by the intracellular and lumenal hydrogen ion concentrations when the ECF volume is expanded or when active sodium reabsorption is inhibited by amiloride.
这些研究的目的是阐明碱性尿液中尿碳酸氢盐浓度与尿减去血二氧化碳分压差值(U-B PCO2)之间关系的基础,从而揭示体内影响集合管氢离子分泌的因素。U-B PCO2用于监测后一参数。在细胞外液(ECF)量正常的犬中,U-B PCO2并非主要受尿碳酸氢盐浓度影响,而是与钠排泄率相关。当尿碳酸氢盐浓度低于60 mmol/L时,氨氯吡咪可消除U-B PCO2。在给予氨氯吡咪的血容量正常的犬中,当尿碳酸氢盐浓度较高时,U-B PCO2与尿碳酸氢盐浓度呈线性相关,但绝对值低于未用氨氯吡咪治疗的血容量正常动物。在ECF量增加的犬中,U-B PCO2低于血容量正常的动物,且U-B PCO2与尿碳酸氢盐浓度无直接关系,也不受钠排泄率影响。在这些情况下,氨氯吡咪对U-B PCO2影响很小。这些结果表明,在血容量正常的犬中,集合管氢离子分泌的幅度主要由钠重吸收产生的电势梯度决定,而在ECF量增加或氨氯吡咪抑制钠主动重吸收时,由细胞内和管腔内氢离子浓度决定。