肾脏泌尿功能的调节 Regulation of urine formation of .PPTVIP

第三节 肾脏泌尿功能的调节 Regulation of urine formation of the kidney 中山大学基础医学院生理学教研室 王庭槐 尿生成的调节 regulation of urine formation 肾血流量的调节 神经—体液调节 regulation of renal blood flow nervous and humonal control (对滤过的调节) (对重吸收和分泌) 自身 神经 体液 调节 调节 调节 ADH 醛固酮 甲状旁腺素 Aldosterone parathyroid hormone 一、抗利尿激素 antidiuretic hormone, ADH 合成部位：视上核(supraoptic nucleus)、室旁核(paraventricular nucleus)合成ADH 运输： 丘脑—垂体束 贮存释放：神经垂体（贮存于膨大神经末梢中） 前激素 ADH 九肽 蛋白水解酶 靶器官：远曲小管集合管 The hypothalamus contains two types of neurons that synthesize ADH in the supraoptic nucleus and paraventricular nucleus.once ADH is synthesized,it is transported down the axons of the neurons to their tips,terminating in the posterior pituitary gland. 作用： 1.提高远曲小管和集合管上皮细胞对水的通透性，促进水的重吸收尿液浓缩、尿量减少（抗利尿）[主要作用]。 The most important renal action of ADH is to increase the water permeability of the distal tubule,collecting tubule.This effect helps the body to conserve water in circumstances such as dehydration. 2.增加内髓部集合管对尿素的通透性并减少肾髓质的血流量。 ADH increases the urea permeability of collecting tubule in inner zone and decreases the blood flow in medulla. 3.促进髓绊升支粗段对NaCl的重吸收，使直小血管收缩。 ADH increases the reabsorption of NaCl in thick segment of ascending limb and so leads to constriction of vasa recta. （一）、作用机理： ADH与远曲小管、集合管上皮细胞管周膜上受体结合 激活膜内的腺苷酸环化酶 上皮细胞中cAMP 管腔膜 中蛋白激酶激活 膜蛋白磷酸化 膜构型改变 水通 道开放管腔膜对水通透性 。 ADH ，水通道小泡内移， 对水通透性 。 ADH combines with the receptor in basolateral membrane and activated the adenylate cyclase,it produces cyclic adenosine monophosphate,which leads to activation of protein kinase in basolateral membrane,then