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清醒大鼠因钾缺乏导致进行性代谢性碱中毒时呼吸代偿的发展。

Development of the respiratory compensation to progressive metabolic alkalosis resulting from potassium depletion in conscious rats.

作者信息

Girard P, Brun-Pascaud M, Pocidalo J J

出版信息

Clin Sci (Lond). 1983 May;64(5):497-504. doi: 10.1042/cs0640497.

Abstract
  1. 288 arterial blood samples were obtained at successive times, through indwelling catheters, from conscious rats subjected to selective dietary potassium restriction for up to 5 weeks. 2. In control rats with unrestricted access to potassium [HCO-3]a = 25.4 mmol/l, pHa = 7.47, PaCO2 = 34 mmHg, PaO2 = 94 mmHg and [K+]a = 4.3 mmol/l were steady and within the range of values reported in conscious rats. Five weeks of isolated potassium restriction resulted in significant hypokalaemia ([K+]a = 2.15 mmol/l) and metabolic alkalosis ([HCO-3]a = 34.1 mmol/1, pH 7.57). This alkalosis, due mostly to H+ transfer into cells, was accompanied by a significant increase in PaCO2 to 36.4 mmHg and decrease in PaO2 to 88 mmHg, contrary to previous reports in man and dog. The administration of neutral sodium phosphate in addition to potassium restriction enhanced both the alkalosis ([HCO-3]a = 42.3 mmol/l, pH 7.61) and its respiratory compensation (PaCO2 = 40.8, PaO2 = 82 mmHg), without altering the PaCO2: [HCO-3]a relationship. 3. The opposite variations of PaCO2 and PaO2 were significantly correlated to the increase in plasma bicarbonate concentration and described best by crossed sigmoid curves. The equations of both curves were calculated; their point of inflection occurred at the same bicarbonate concentration (36 mmol/l). The maximum intensity of respiratory compensation (0.62 mmHg PaCO2 for each mmol [HCO-3]a/l) observed at this point fell within the range of values yielded by previous estimations.
摘要
  1. 通过留置导管,在长达5周的选择性饮食钾限制条件下,从清醒大鼠身上连续采集288份动脉血样本。2. 在钾摄入不受限制的对照大鼠中,动脉血[HCO₃⁻]a = 25.4 mmol/L,pHa = 7.47,PaCO₂ = 34 mmHg,PaO₂ = 94 mmHg,[K⁺]a = 4.3 mmol/L,这些指标稳定且在清醒大鼠报告的数值范围内。单独进行五周的钾限制导致显著的低钾血症([K⁺]a = 2.15 mmol/L)和代谢性碱中毒([HCO₃⁻]a = 34.1 mmol/L,pH 7.57)。这种主要由于H⁺转移到细胞内引起的碱中毒,伴随着PaCO₂显著升高至36.4 mmHg以及PaO₂降低至88 mmHg,这与之前关于人和狗的报道相反。除了钾限制外,给予中性磷酸钠会加重碱中毒([HCO₃⁻]a = 42.3 mmol/L,pH 7.61)及其呼吸代偿(PaCO₂ = 40.8,PaO₂ = 82 mmHg),而不改变PaCO₂:[HCO₃⁻]a关系。3. PaCO₂和PaO₂的相反变化与血浆碳酸氢盐浓度的增加显著相关,并且用交叉的S形曲线能最好地描述。计算了两条曲线的方程;它们的拐点出现在相同的碳酸氢盐浓度(36 mmol/L)处。此时观察到的呼吸代偿最大强度(每mmol [HCO₃⁻]a/L对应0.62 mmHg PaCO₂)落在先前估计值的范围内。

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