acid-base disturbance(酸碱平衡紊乱)演示讲稿.ppt

Acid-base disturbance ;Section 1. Acid-Base Balance; Homeostasis is very important for life. Acid-base balance is one of the major requirements ( volume, osmolarity of the body fluid, etc.). The basic meaning of acid-base balance is the stable [H+] in the body fluid. ;(1) Sources of acid and base;;1) Volatile acid;2) unvolatile acid (fixed acid);1) Chemical buffers; buffer system the % account ----------------------------------------------------------------------------------- HCO-3/H2CO3 53% Hb-/HHb HbO-2/HHbO2 35% Pr-/HPr 7% Phosphate 5% -------------------------------------------------------- NaHCO3 can be effectively eliminated by kidneys and (H2CO3 ←→H2O + CO2) CO2 can be effectively eliminated by the lung.---- “open buffer system” HCO-3/H2CO3 is the most important buffer pair.; CO2 Cl- ;2) Respiratory regulation;Increased PaCO2 (60mmHg, 8kPa) and the decreased pH of ESF can stimulate the respiratory center via central or peripheral chemoreceptors and increase the depth of respiration (hyperventilation, tidal volume increased). More CO2 can be eliminated from lung, so that the [H2CO3] in blood will fall to normal range, the pH will increase to normal by regulate the ratio of [HCO3-] and [H2CO3] . ;Characteristics ; 3) Renal regulation; (a) Excretion of acids 1) Secretion of H+, NH4+ 2) Excrete all the nonvolatile acid (70~100 mmol/ per day) produced from catabolism of food. (b) Reabsorb properly the bicarbonate filtered from glomerulus. When the pH is decreased, more bicarbonate needs to be reabsorbed. If the pH is increased, more bicarbonate will be eliminated.; Mechanisms of H+excretion and HCO3– reabsorption:;① in proximal tubule: Na+-H+ antiportor （NHE）;Via sec