2.抗利尿激素 (antidiuretic hormone, ADH) ECF凌 透压↑ 渗透压 肾重吸□ECF量↑ 感受器 ADH↑ 收水↑渗透压 有效循 量感受器 环血量↓
2.抗利尿激素 (antidiuretic hormone , ADH) ECF渗 透压↑ 有效循 环血量↓ 渗透压 感受器 ADH↑ 肾重吸 收水↑ ECF量↑ 渗透压↓ 容量感受器
3醛固酮( aldosterone) 有效循 环血量↓ 醛固酮↑ 肾重吸收 Na+个H2O↑ ECF量个 低血Na+ 高血K
3.醛固酮(aldosterone) 有效循 环血量↓ 醛固酮↑ 肾重吸收 Na+↑H2O↑ ECF量↑ 低血Na+ 高血K+
Case stud 42岁男性,因恶心、呕吐、腹胀和腹部 绞痛3天入院。 既往史:20岁儆过阚尾切除术。 体检:T38.7°C,脉搏104beat/min BP115/70 mmHg 腹胀,有压痛和反跳痛。 皮肤和舌干燥,尿量5m/h 化验:血[Na+]152mmo/L, [Cl]108mmol/L, [K+]5.4mmol/L, 尿比重1038
42岁男性，因恶心、呕吐、腹胀和腹部 绞痛3天入院。 既往史：20岁做过阑尾切除术。 体检： T 38.7C，脉搏104 beat/min BP 115/70 mmHg 腹胀，有压痛和反跳痛。 皮肤和舌干燥，尿量5ml/h 化验：血[Na＋]152mmol/L, [Cl- ]108mmol/L, [K+] 5.4mmol/L， 尿比重1.038 Case study
Case study woman 38, 2-day history of weakness and postura| dizziness(直立性眩晕) History: laxative(泻药) abuse with multiple bowel movements each day Physical examination BP 110/60 mmHg falls to 80/50 mmHg HR 100 beats/min and regular Skin turgor is poor The mucous membrane is dry
woman 38 ， 2-day history of weakness and postural dizziness（直立性眩晕 ） History：laxative（泻药）abuse with multiple bowel movements each day Physical examination： BP 110/60 mmHg falls to 80/50 mmHg HR 100 beats/min and regular Skin turgor is poor The mucous membrane is dry Case study
Laboratory test Na=140 mmol/L IK =3.3 mmol/L ICH=116 mmol/L Urine Nat=g mmo/L bun=40 mg/dL Arterial pH=7. 25 HCO3=12 mmol/L Paco,=28 mmHg
Laboratory test [Na+ ] = 140 mmol/L [K+ ] = 3.3 mmol/L [Cl- ] ＝ 116 mmol/L Urine [Na+ ] = 9 mmol/L BUN = 40 mg/dL Arterial pH = 7.25 [HCO3 - ] = 12 mmol/L PaCO2 = 28 mmHg