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细胞外液量和血浆碳酸氢盐浓度对大鼠近端酸化的影响。

Effects of extracellular fluid volume and plasma bicarbonate concentration on proximal acidification in the rat.

作者信息

Alpern R J, Cogan M G, Rector F C

出版信息

J Clin Invest. 1983 Mar;71(3):736-46. doi: 10.1172/jci110821.

Abstract

The effects of systemic bicarbonate concentration and extracellular fluid volume status on proximal tubular bicarbonate absorption, independent of changes in luminal composition and flow rate, were examined with in vivo luminal microperfusion of rat superficial proximal convoluted tubules. Net bicarbonate absorption and bicarbonate permeability were measured using microcalorimetry. From these data, net bicarbonate absorption was divided into two parallel components: proton secretion and passive bicarbonate diffusion. The rate of net bicarbonate absorption was similar in hydropenic and volume-expanded rats when tubules were perfused with 24 mM bicarbonate, but was inhibited in volume-expanded rats when tubules were perfused with 5 mM bicarbonate. Volume expansion caused a 50% increase in bicarbonate permeability, which totally accounted for the above inhibition. The rate of proton secretion was unaffected by volume expansion in both studies. The rate of net bicarbonate absorption was markedly inhibited in alkalotic expansion as compared with isohydric expansion. Bicarbonate permeabilities were not different in these two conditions, and the calculated rates of proton secretion were decreased by greater than 50% in alkalosis. Net bicarbonate absorption was stimulated in acidotic rats compared to hydropenic rats. This stimulation was attributable to a 25% increase in the rate of proton secretion. We conclude that (a) proton secretion is stimulated in acidosis, inhibited in alkalosis, and is not altered by volume status; (b) bicarbonate permeability is increased by volume expansion but is not altered by increases in plasma bicarbonate concentration; (c) when luminal bicarbonate concentrations are similar to those of plasma, net bicarbonate absorption is dominated by proton secretion and is thus sensitive to peritubular bicarbonate concentrations, and insensitive to extracellular fluid volume; (d) when luminal bicarbonate concentrations are low and proton secretion is slowed, bicarbonate permeability and thus extracellular fluid volume have a greater influence on net bicarbonate absorption.

摘要

通过对大鼠浅表性近端曲管进行体内管腔微灌注,研究了全身碳酸氢盐浓度和细胞外液容量状态对近端小管碳酸氢盐吸收的影响,该影响独立于管腔成分和流速的变化。使用微量量热法测量净碳酸氢盐吸收和碳酸氢盐通透性。根据这些数据,净碳酸氢盐吸收分为两个平行成分:质子分泌和碳酸氢盐被动扩散。当用24 mM碳酸氢盐灌注小管时,禁水和容量扩张大鼠的净碳酸氢盐吸收速率相似,但当用5 mM碳酸氢盐灌注小管时,容量扩张大鼠的净碳酸氢盐吸收速率受到抑制。容量扩张使碳酸氢盐通透性增加50%,这完全解释了上述抑制作用。在两项研究中,质子分泌速率均不受容量扩张的影响。与等渗扩张相比,碱中毒扩张时净碳酸氢盐吸收速率明显受到抑制。这两种情况下碳酸氢盐通透性无差异,碱中毒时计算得出的质子分泌速率降低超过50%。与禁水大鼠相比,酸中毒大鼠的净碳酸氢盐吸收受到刺激。这种刺激归因于质子分泌速率增加25%。我们得出以下结论:(a) 酸中毒时质子分泌受到刺激,碱中毒时受到抑制,且不受容量状态改变的影响;(b) 容量扩张使碳酸氢盐通透性增加,但血浆碳酸氢盐浓度升高不会改变其通透性;(c) 当管腔碳酸氢盐浓度与血浆浓度相似时,净碳酸氢盐吸收以质子分泌为主,因此对肾小管周围碳酸氢盐浓度敏感,而对细胞外液容量不敏感;(d) 当管腔碳酸氢盐浓度较低且质子分泌减慢时,碳酸氢盐通透性以及细胞外液容量对净碳酸氢盐吸收的影响更大。

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