Brandell R A, Scaletscky R, Koch M O
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Urology. 1994 Sep;44(3):343-7. doi: 10.1016/s0090-4295(94)80091-x.
This study was conducted to quantitate and compare urinary solute transport by stomach and ileum using an in vivo rat model.
An artificial urine solution was perfused through isolated gastric and ileal segments in the anesthetized rat. Concentrations of solutes and a volume marker were periodically determined in the perfusate and net solute flux was calculated.
The stomach secretes less sodium and very little bicarbonate in comparison with ileum. Hydrogen ion and chloride are absorbed by ileum but secreted in large quantities by the stomach. Ammonium, potassium, and urea are absorbed by both segments but to a much lesser degree in the stomach. Overall, there was a net osmolar absorption by ileum, and a net secretion by the stomach. Both segments secrete water to a similar degree.
These findings both suggest the mechanism of the hypochloremic metabolic alkalosis seen after urinary reconstruction with the stomach and provide insight into potential therapeutic approaches. Solute fluxes in both the stomach and the ileum are consistent with the known physiology of these segments.
本研究旨在使用大鼠体内模型对胃和回肠的尿溶质转运进行定量和比较。
在麻醉的大鼠中,将人工尿液溶液灌注通过分离的胃和回肠段。定期测定灌注液中溶质和体积标记物的浓度,并计算净溶质通量。
与回肠相比,胃分泌的钠较少,碳酸氢盐极少。氢离子和氯离子在回肠被吸收,但在胃中大量分泌。铵、钾和尿素在两个肠段均被吸收,但在胃中的吸收程度要小得多。总体而言,回肠有净渗透压吸收,而胃有净分泌。两个肠段分泌水的程度相似。
这些发现既提示了胃代膀胱术后出现低氯性代谢性碱中毒的机制,也为潜在的治疗方法提供了思路。胃和回肠中的溶质通量与这些肠段已知的生理学一致。