纠正慢性肾衰竭患者的酸中毒可减少蛋白质降解和氨基酸氧化。
Correction of acidosis in humans with CRF decreases protein degradation and amino acid oxidation.
作者信息
Reaich D, Channon S M, Scrimgeour C M, Daley S E, Wilkinson R, Goodship T H
机构信息
Department of Medicine, University of Newcastle upon Tyne, United Kingdom.
出版信息
Am J Physiol. 1993 Aug;265(2 Pt 1):E230-5. doi: 10.1152/ajpendo.1993.265.2.E230.
The effect of correction of acidosis in chronic renal failure (CRF) was determined from the kinetics of infused L-[1-13C]leucine. Nine CRF patients were studied before (acid) and after two 4-wk treatment periods of sodium bicarbonate (NaHCO3) and sodium chloride (NaCl) (pH: acid 7.31 +/- 0.01, NaHCO3 7.38 +/- 0.01, NaCl 7.30 +/- 0.01). Leucine appearance from body protein (PD), leucine disappearance into body protein (PS) and leucine oxidation (O) decreased significantly with correction of acidosis (PD: acid 122.4 +/- 6.1, NaHCO3 88.3 +/- 6.9, NaCl 116.2 +/- 9.1 mumol.kg-1.h-1, acid vs. NaHCO3 P < 0.01, NaHCO3 vs. NaCl P < 0.01, acid vs. NaCl NS; PS: acid 109.4 +/- 5.6, NaHCO3 79.0 +/- 6.3, NaCl 101.3 +/- 7.7 mumol.kg-1.h-1, acid vs. NaHCO3 P < 0.01, NaHCO3 vs. NaCl P < 0.01, acid vs. NaCl NS; O: acid 13.0 +/- 1.2, NaHCO3 9.2 +/- 0.9, NaCl 15.0 +/- 1.9 mumol.kg-1.h-1, acid vs. NaHCO3 P < 0.05, NaHCO3 vs. NaCl P < 0.01, acid vs. NaCl NS). There were no significant changes in plasma amino acid concentrations. These results confirm that correction of acidosis in chronic renal failure removes a potential catabolic factor.
通过输注L-[1-13C]亮氨酸的动力学来确定纠正慢性肾衰竭（CRF）酸中毒的效果。对9例CRF患者在（酸中毒状态下）治疗前以及经过两个为期4周的碳酸氢钠（NaHCO3）和氯化钠（NaCl）治疗期后进行了研究（pH值：酸中毒状态下为7.31±0.01，NaHCO3治疗后为7.38±0.01，NaCl治疗后为7.30±0.01）。随着酸中毒的纠正，来自机体蛋白质的亮氨酸出现率（PD）、进入机体蛋白质的亮氨酸消失率（PS）和亮氨酸氧化率（O）均显著降低（PD：酸中毒状态下为122.4±6.1，NaHCO3治疗后为88.3±6.9，NaCl治疗后为116.2±9.1μmol·kg-1·h-1，酸中毒状态与NaHCO3治疗后相比P<0.01，NaHCO3治疗后与NaCl治疗后相比P<0.01，酸中毒状态与NaCl治疗后相比无显著性差异；PS：酸中毒状态下为109.4±5.6，NaHCO3治疗后为79.0±6.3，NaCl治疗后为101.3±7.7μmol·kg-1·h-1，酸中毒状态与NaHCO3治疗后相比P<0.01，NaHCO3治疗后与NaCl治疗后相比P<0.01，酸中毒状态与NaCl治疗后相比无显著性差异；O：酸中毒状态下为13.0±1.2，NaHCO3治疗后为9.2±0.9，NaCl治疗后为15.0±1.9μmol·kg-1·h-1，酸中毒状态与NaHCO3治疗后相比P<0.05，NaHCO3治疗后与NaCl治疗后相比P<0.01，酸中毒状态与NaCl治疗后相比无显著性差异）。血浆氨基酸浓度无显著变化。这些结果证实，纠正慢性肾衰竭的酸中毒可消除一个潜在的分解代谢因素。
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