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甲状旁腺激素对肾碳酸氢盐重吸收作用的微穿刺研究。

A micropuncture study of the effect of parathyroid hormone on renal bicarbonate reabsorption.

作者信息

Bank N, Aynediian H S

出版信息

J Clin Invest. 1976 Aug;58(2):336-44. doi: 10.1172/JCI108477.

Abstract

Renal micropuncture and clearance experiments were carried out in rats to study the effect of parathyroid hormone (PTH) on renal tubular HCO-/3 reabsorption. The rats were studied during an initial period of parathyroid deficiency (acute thyroidparathyroidectomy, TPTX) and during infusion of large amounts of bovine PTH. Under normal acid-base conditions, PTH administration to TPTX rats caused a significant rise in proximal tubular fluid HCO-/3 concentration (TFHCO-/3), a decrease in fluid reabsorption, and a fall in proximal HCO-/3 reabsorption from 94.0 to 88.2% (P less than 0.01). In control experiments with mannitol infusion, a comparable reduction in proximal fluid reabsorption occurred without any significant effect on intraluminal HCO-/3 concentration. During acute intravenous HCO-/3 loading, PTH inhibited proximal HCO-/3 reabsorption. However, no change in whole kidney HCO-/3 reabsorption was observed in these experiments or in the animals studied under normal acid-base conditions. The findings are consistent with the view that PTH inhibits proximal tubular HCO-/3 reabsorption with normal or high filtered loads of HCO-/3, but distal segments of the nephron are able to reabsorb the excess delivered from the proximal tubule. Measurements of urinary ammonium and titratable acid indicate that net acid excretion (NH+/4 + TA -- HCO-/3) increases significantly after PTH administration. These results do not provide support for the view that PTH excess causes metabolic acidosis by reducing renal acid excretion.

摘要

在大鼠身上进行了肾微穿刺和清除实验,以研究甲状旁腺激素(PTH)对肾小管HCO₃⁻重吸收的影响。在甲状旁腺功能减退的初始阶段(急性甲状腺甲状旁腺切除术,TPTX)以及输注大量牛PTH期间对大鼠进行研究。在正常酸碱条件下,给TPTX大鼠注射PTH会导致近端肾小管液HCO₃⁻浓度(TFHCO₃⁻)显著升高,液体重吸收减少,近端HCO₃⁻重吸收从94.0%降至88.2%(P<0.01)。在输注甘露醇的对照实验中,近端液体重吸收有类似程度的降低,但对管腔内HCO₃⁻浓度没有任何显著影响。在急性静脉注射HCO₃⁻负荷期间,PTH抑制近端HCO₃⁻重吸收。然而,在这些实验中以及在正常酸碱条件下研究的动物中,未观察到全肾HCO₃⁻重吸收有变化。这些发现与以下观点一致,即PTH在HCO₃⁻滤过负荷正常或较高时抑制近端肾小管HCO₃⁻重吸收,但肾单位的远端部分能够重吸收从近端小管输送来的过量HCO₃⁻。尿铵和可滴定酸的测量表明,注射PTH后净酸排泄(NH₄⁺ + TA - HCO₃⁻)显著增加。这些结果不支持PTH过量通过减少肾酸排泄导致代谢性酸中毒这一观点。

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