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犬急性高碳酸血症时远端酸化作用减弱。

Decreased distal acidification in acute hypercapnia in the dog.

作者信息

Adrogué H J, Stinebaugh B J, Gougoux A, Lemieux G, Vinay P, Tam S C, Goldstein M B, Halperin M L

出版信息

Am J Physiol. 1983 Jan;244(1):F19-27. doi: 10.1152/ajprenal.1983.244.1.F19.

Abstract

The present studies evaluate the effect of acute hypercapnia on distal nephron H+ secretion (DNH+S) in vivo by means of the urine-blood PCO2 difference (U-B PCO2) in alkaline urine. Bicarbonaturia was induced by either a sodium bicarbonate infusion or L-lysine administration. Our results demonstrate that the U-B PCO2, as a function of the urinary bicarbonate concentration, was significantly lower during acute respiratory acidosis; this effect was not dependent on changes in glomerular filtration rate and/or fractional excretion of sodium, potassium, and chloride. Infusion of the sodium salts of sulfate, a nonreabsorbable anion, did not correct the diminished U-B PCO2. Amiloride caused the U-B PCO2 to fall in normocapnic dogs but not in hypercapnic dogs. When hypercapnia was superimposed in dogs with extracellular fluid volume contraction, there were no changes in the U-B PCO2. This study indicates that acute hypercapnia in the intact dog decreases DNH+S and is compatible with an effect of hypercapnia on the voltage-dependent component of urine acidification. The mechanism appears to be direct rather than secondary to factors that influence the rate of sodium delivery to the distal nephron.

摘要

本研究通过碱性尿液中的尿-血二氧化碳分压差值(U-B PCO₂)评估急性高碳酸血症对体内远端肾单位H⁺分泌(DNH⁺S)的影响。通过输注碳酸氢钠或给予L-赖氨酸诱导产生重碳酸盐尿。我们的结果表明,作为尿中碳酸氢盐浓度函数的U-B PCO₂在急性呼吸性酸中毒期间显著降低;这种效应不依赖于肾小球滤过率和/或钠、钾、氯的分数排泄的变化。输注不可重吸收阴离子硫酸盐的钠盐并不能纠正降低的U-B PCO₂。氨氯吡咪使正常碳酸血症犬的U-B PCO₂降低,但对高碳酸血症犬无效。当在细胞外液量收缩的犬中叠加高碳酸血症时,U-B PCO₂没有变化。本研究表明,完整犬的急性高碳酸血症会降低DNH⁺S,并且与高碳酸血症对尿液酸化的电压依赖性成分的影响一致。其机制似乎是直接的,而非继发于影响钠输送至远端肾单位速率的因素。

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