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过度通气对远端肾单位氢离子分泌的影响。

The effect of hyperventilation on distal nephron hydrogen ion secretion.

作者信息

Giammarco R A, Goldstein M B, Halperin M L, Stinebaugh B J

出版信息

J Clin Invest. 1976 Jul;58(1):77-82. doi: 10.1172/JCI108462.

Abstract

This study was designed to determine the effect of acute hyperventilation on distal nephron hydrogen ion secretion. The blood PCO2 declined and stabilized rapidly when bicarbonate loaded rats were hyperventilated. In contrast, the urine PCO2 declined slowly, resulting in an early increase in the urine minus blood (U-B) PCO2 which could not be obliterated by carbonic anhydrase infusion. Within approximately 50 min, the U-B PCO2 in the hyperventilated and carbonic anhydrase infused rats approached zero. Consequently, equilibrium between collecting duct urine and arterial blood PCO2 was then presumed to exist. This provided the basis for the subsequent studies on a series of rats. The U-B PCO2 decreased from a control of 22+/-1 mm Hg (mean+/-SEM) to 11+/-2 mm Hg (mean+/-SEM) with hypocapnia, and rose again to its control value when the blood PCO2 returned to prehyperventilation values. This decline in U-B PCO2 with acute hyperventilation could not be attributed to changes in urine flow, phosphate, or bicarbonate excretion, suggesting, therefore, a decrease in distal nephron (probably collecting duct) hydrogen ion secretion with acute hyperventilation. Possible pitfalls in the interpretation of the UB PCO2 are illustrated.

摘要

本研究旨在确定急性过度通气对远端肾单位氢离子分泌的影响。当给碳酸氢盐负荷的大鼠进行过度通气时,血液PCO2迅速下降并稳定。相比之下,尿液PCO2下降缓慢,导致尿液减去血液(U-B)PCO2早期升高,而输注碳酸酐酶并不能消除这种升高。在大约50分钟内,过度通气并输注碳酸酐酶的大鼠的U-B PCO2接近零。因此,推测此时集合管尿液与动脉血PCO2之间存在平衡。这为后续一系列大鼠的研究提供了基础。低碳酸血症时,U-B PCO2从对照值22±1 mmHg(均值±标准误)降至11±2 mmHg(均值±标准误),当血液PCO2恢复到过度通气前的值时,又回升至对照值。急性过度通气时U-B PCO2的这种下降不能归因于尿流、磷酸盐或碳酸氢盐排泄的变化,因此提示急性过度通气时远端肾单位(可能是集合管)氢离子分泌减少。文中说明了UB PCO2解释中可能存在的陷阱。

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Significance of carbon dioxide tension in urine.尿液中二氧化碳张力的意义。
Am J Physiol. 1952 Jun;169(3):596-608. doi: 10.1152/ajplegacy.1952.169.3.596.

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