Cogan M G
J Clin Invest. 1984 Dec;74(6):1942-7. doi: 10.1172/JCI111614.
The hyperbicarbonatemia of chronic respiratory acidosis might be maintained by a reduction in filtration rate or an enhancement of tubular bicarbonate reabsorption. To investigate this question, 12 Munich-Wistar rats were exposed to a 10% CO2 atmosphere for 6-8 d. Chronic respiratory acidosis developed, with arterial pH 7.30 +/- 0.01, partial pressure of CO2 (pCO2) 80 +/- 2 mmHg, and total CO2 concentration 45 +/- 1 mM. Single nephron glomerular filtration rate was normal (42 +/- 1 nl/min). Chronic hypercapnia caused absolute proximal reabsorption to be significantly stimulated (1,449 +/- 26 pmol/min) as compared with reabsorption previously observed in normal animals (1,075 +/- 74 pmol/min) or in animals subjected to acute hypercapnia (1,200 +/- 59 pmol/min). This is the first demonstration that proximal bicarbonate reabsorption can be stimulated above normal euvolemic values. When eight animals were subsequently allowed to return toward a normocapnic state (arterial pCO2 46 +/- 1 mmHg) over the course of 1-1.5 h, bicarbonate reabsorption was still significantly higher (1,211 +/- 34 pmol/min) than in similarly alkalotic, normocapnic control groups (994 +/- 45 pmol/min). In conclusion, chronic, but not acute, hypercapnia stimulates absolute proximal bicarbonate reabsorption to exceed the level found in normal euvolemic rats.
慢性呼吸性酸中毒时的高碳酸氢盐血症可能是通过滤过率降低或肾小管对碳酸氢盐重吸收增强来维持的。为研究此问题,将12只慕尼黑-威斯塔大鼠置于10%二氧化碳环境中6 - 8天。出现了慢性呼吸性酸中毒,动脉血pH为7.30±0.01,二氧化碳分压(pCO₂)为80±2 mmHg,总二氧化碳浓度为45±1 mM。单肾单位肾小球滤过率正常(42±1 nl/min)。与正常动物先前观察到的重吸收(1075±74 pmol/min)或急性高碳酸血症动物(1200±59 pmol/min)相比,慢性高碳酸血症使近端绝对重吸收显著增加(1449±26 pmol/min)。这是首次证明近端碳酸氢盐重吸收可被刺激至高于正常血容量状态下的值。随后,当8只动物在1 - 1.5小时内恢复至正常碳酸血症状态(动脉pCO₂ 46±1 mmHg)时,碳酸氢盐重吸收仍显著高于同样处于碱中毒、正常碳酸血症的对照组(994±45 pmol/min)(1211±34 pmol/min)。总之,慢性而非急性高碳酸血症刺激近端绝对碳酸氢盐重吸收超过正常血容量大鼠的水平。