钾代谢障碍 酸碱平衡紊乱

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1、DisordersofPotassiumMetabolismOutlineNormalpotassiummetabolismandregulationHypokalemiaHyperlalemiaCasediscussion1.thetotalpotassiumofbody:intracellular:98％（140-160mmol/L）extracellular：2％（3.5-4.5mmol/L）Normalpotassiummetabolism2.potassiumpresentsinthefood,suchasmilk,peanutpotatoes

2、,saltsubstitute.Potassiumexcretepathway:kidneythroughurine:90％Stool(feces):10％Sweatnormalserumpotassium:3.5-5.5mmol/Lbalancebetweenintra-andextracellularK+normal:15h3.regulationofpotassiumhomeostasisTranscellulartransferRenalregulation(1)PotassiumtranscellulartransferPump-leakm

3、echanismfactors:PotassiumconcentrationinECFAcid-basebalanceInsulinCatecholamineOsmolarityExerciseTotalbodypotassium(2).RenalregulationforpotassiumexcretionGlomerularfiltrationReabsorptionbytheproximaltubuleandtheloopofHenleRegulationofpotassiumexcretioninthedistalandcollectingtub

4、ulesSodium-potassiumATPasePermeabilityofluminalmembraneforpotassiumReabsorptionincollectingtubulesHydrogen-potassiumATPase-protonpumpMechanismofpotassiumexcretionindistalandcollectingtubules:Influencingfactorsofpotassiumexcretionindistalandcollectingtubules:Potassiumconcentration

5、inECFAldosteroneDistalflowrateAcid-basebalance(3)PotassiumexcretionincolonThesameastheexcretioninkidney4.physiologicalfunctionofpotassiummaintaincellularmetabolismmaintaincellularrestingmembranepotentialregulatetheosmolarityandacid-basebalanceDisorderofpotassiummetabolismNormalse

6、rumpotassium:3.5-5.5mmol/LHypokalemiaHyperkalemia5.influencingfacterofpotassiumhomeostasisacidosisalkalosishypoxiaseruminsulinserumdamageofcells[K+]ADS[K+]catabolismanabolismdistalflowratedistalflowrate1.Definition:Hypokalemiaisdefinedasadecreaseinserumpotassiumlevellessthan3.5mm

7、ol/L.Ⅱ.hypokalemia2.causes(1).intake↓(2).discharge↑①digestivetract②kidneys：③skinGI:vomiting;diarrhea;GastrointestinalsuctionSkin:excessivesweatsfurosemidediureticlossesdiamoxdiureticphaseofARFrenal:primaryhyperaldosteronismlackofmagnesiumrenaltubularacidosisosmoticdiuresis(3).Abn

8、ormalitydistributionofpotassiummoveintoc