第四章 酸碱平衡和酸碱平衡紊乱.ppt

(Acid-base disturbances)
第四章
酸碱平衡紊乱
病理生理教研室
吴立玲
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+] = mmol/L[Cl-] = 116 mmol/LUrine [Na+] = 9 mmol/LBUN = 40 mg/dL
Arterial pH = [HCO3-] = 12 mmol/L PaCO2 = 28 mmHg
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)
(Acid-base balance  and its regulation )
第一节酸碱平衡及其调节
(一)酸性物质的来源
挥发酸(volatile acid)
固定酸(fixed acid)
一、酸碱物质的来源
(Sources of acid and base)
(Source of acid)
经肺呼出
1. Volatile acid
CO2
+
H2O
H2CO3
CA
2. Fixed acid
H2SO4
HCl
有机酸
经肾排出
H3PO4
(Sources of base)
(二) 碱性物质的来源
碱性氨基酸分解
有机酸盐转变
3CO2+2H2O+NaHCO3
COOH CHOHCH2COONa
苹果酸钠
3O2