4)renal regulation (1 acidification of proximal renal tubule 血管 肾小管上皮管腔 N Nat cl HCO 3 K H2 CO3 H2 CO3 NH3 Nat CA HCO3 H20+CO2 H20 泌与Cr重吸收拮抗与泌NH3协同
4) renal regulation ① acidification of proximal renal tubule 血管 肾小管上皮 管腔 Na+ ClHCO- 3 H2CO3 H20 泌H+ 与Cl- 重吸收拮抗与泌NH3协同 K+ NH3 Na+ H+ H2CO3 Na+ C.A. HCO- 3 H2O+CO2
@2 acidification of distal renal tubule 肾小管上皮细胞 H -pump H2CO3→H+ NH3 NH4 HCO 3 H20+CO2 K 泌Ⅳ与泌K+拮抗,与泌NH3协同, 与肾小管液流量正变
② acidification of distal renal tubule H+ -pump NH+ 4 泌H+与泌K+拮抗，与泌NH3协同， 与肾小管液流量正变 肾小管上皮细胞 H2CO3 H+ NH3 HCO- 3 H2O+CO2 K+
II. parameters of acid-base 1. pH important and inexact parameter normal range: 7.35-7.45 2. Paco2 partial pressure of co2 of dissolved in arterial plasma(respiratory parameter) normal range: 4.4-6.25kPa(33-46mmHg primary change. respiratory acidosis - Paco, T respiratory alkalosis→PaCO2↓ secondary change: meta bolic acidosis PacO,I metabolic alkalosis Paco, l
Ⅱ.parameters of acid-base 1. pH important and inexact parameter normal range: 7.35~7.45 2. PaCO2 partial pressure of CO2 of dissolved in arterial plasma (respiratory parameter) normal range: 4.4~6.25kPa(33~46mmHg) primary change: respiratory acidosis PaCO2 respiratory alkalosis PaCO2 secondary change: metabolic acidosis PaCO2 metabolic alkalosis PaCO2
3. standard bicarbonate(sb and actual bicarbonate (aB) SB: HCO 31 in plasma under standard condition (38C; PO2=150mmHg; PCO2=40mmHg) AB: HCO 3 in plasma under actual condition Normal range: 22-27 mmol/L; AB=SB 4. buffer base (bb) sum of all buffer base in blood normal range: 45-55mmol/L 5. base excess(be) normal range:±3mmo/L
3. standard bicarbonate(SB) and actual bicarbonate(AB) SB: [HCO- 3] in plasma under standard condition (38℃; PO2=150mmHg; PCO2=40mmHg) AB: [HCO- 3] in plasma under actual condition Normal range: 22~27mmol/L ; AB=SB 4. buffer base(BB) sum of all buffer base in blood normal range: 45 ~ 55mmol/L 5. base excess(BE) normal range: ±3mmol/L
6. anion gap (AG) N AG Normal range: 12 +2 mmol/L
6. anion gap (AG) + - Normal range: 12 ± 2 mmol/L Na+ ClAG HCO- 3