医学肾脏泌尿功能的调节.pptVIP

水利尿water diuresis 大量饮清水 尿量 饮1000ml清水，隔30分钟 尿量 ，（1小时末达高峰，2—3小时恢复） 饮1000ml NS，隔30分钟 变化不大 ;2、循环血量的改变（容量感受器途径） 过度输液，血量过多(+) 左心房内膜下容量感受器 ?迷走N，传入冲动 中枢，间接抑制下丘脑—垂体后叶系统 释放ADH 远曲小管集合管对水通透性 对水重 吸收 尿量 。 When blood volume increases because of excess transfuse, the volume receptor in endometrium of left atrium sends impulse through Vagus nerve to center and inhibit the release of ADH by Hypothalami- Pituitary posterior lobe system,so the water permeability in distal tubule and collecting tubule decreases,therefore the reaborption of water decreases and the urine volume increases. ;3、其它因素 ①AP (+) 颈动脉窦压力感受器 窦N ADH反射性释放 尿量 ②痛刺激、情绪紧张 ADH 尿量 ③弱冷刺激 ADH 尿量 ④下丘脑病变累及视上核、室旁核 ADH合成 释放障碍 尿崩症(diabetes insipidus)。 When arterial pressure increases,pressorecepto in carotid sinus sends signals to hypothalamic nuclei through sinus nerve that decreases ADH secretion.ADH secretion can also be controlled by other stimuli such as pain and nervous mood. ;二、醛固酮的作用（Aldosterone）;（一）作用机制： 醛固酮进入远曲小管集合管的上皮细胞后 与胞浆受体结合 形成激素—胞浆受体复合物 通过核膜 与核中受体结合 激素—核受体复合物 促进mRNA的合成 醛固酮 促进小管上皮细胞Na+ 泵运转 诱导蛋白 促进生化氧化提供ATP 促进加强Na+ 增加管腔膜对Na+ 通透性 的主动重吸收(保Na+) 造成小管腔内负电位 K+被分泌到 小管液（排K+) Aldosterone diffuses readily to the interior of the tubulaar epithelial cells and combines with a highly specific cytoplasmic receptor protein,then the aldosterone-receptor complex diffuses into the nucleus where it may undergo further alterations,finally inducing one or more specific portions of the DNA to form one or more types of messenger RNA related to the process of sodium and potassium transport.;（心房利尿肽ANP）28个氨基酸残基 集合管对Na+重吸 收