第四章 酸碱平衡紊乱 (Acid-base disturbances) 病狸生理教研宣 吴立玲
(Acid-base disturbances) 第四章 酸碱平衡紊乱 病理生理教研室 吴立玲
Case study 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
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 K+=3.3 mmol/L Cr=116 mmol/L Urine na =9 mmol/L BUN =40 mg/dL Arterial ph=7.25 JHCO3=12 mmol/L aco2=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
酸碱平衡紊乱 (Acid-base disturbance) 因酸喊负荷过度、不足或 调节机制障碍导致体液酸碱度 稳定性失衡的病理过程
因酸碱负荷过度、不足或 调节机制障碍导致体液酸碱度 稳定性失衡的病理过程。 酸碱平衡紊乱 (Acid-base disturbance)
第一节 酸碱平衡及其调节 (Acid-base balance and its regulation
(Acid-base balance and its regulation ) 第一节 酸碱平衡及其调节
酸碱物质的亲源 (Sources of acid and base) (一)酸性物质的来源 (Source of acid) ☆挥发酸( volatile acid) ☆固定酸 (fixed acid)
(一)酸性物质的来源 v 挥发酸(volatile acid) v 固定酸(fixed acid) 一 、酸碱物质的来源 (Sources of acid and base) (Source of acid)
1. Volatile acid CA (CO2)+(H20H2 CO3 经肺呼出
经肺呼出 1. Volatile acid CO2 ＋ H2O H2CO3 CA
2. Fixed acid H3PO4 H2 SO4 HCI 有机酸 经肾排出
2. Fixed acid H2SO4 HCl 有机酸 经肾排出 H3PO4
(二)碱性物质的来勰 (Sources of base) ◇碱性氨基酸分解 有机酸盐转变
(Sources of base) (二) 碱性物质的来源 v 碱性氨基酸分解 v 有机酸盐转变
COOH CHOH 302 CH2 3C02+2H20+NaHCO3 CooNa 苹果酸钠
3CO2+2H2O+NaHCO3 COOH CHOH CH2 COONa 苹果酸钠 3O2