钾代谢障碍 酸碱平衡紊乱课件_1

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

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

3、n(1)PotassiumtranscellulartransferPump-leakmechanismfactors:PotassiumconcentrationinECFAcid-basebalanceInsulinCatecholamineOsmolarityExerciseTotalbodypotassium(2).RenalregulationforpotassiumexcretionGlomerularfiltrationReabsorptionbytheproximaltubuleandthelo

4、opofHenleRegulationofpotassiumexcretioninthedistalandcollectingtubulesSodium-potassiumATPasePermeabilityofluminalmembraneforpotassiumReabsorptionincollectingtubulesHydrogen-potassiumATPase-protonpumpMechanismofpotassiumexcretionindistalandcollectingtubules:I

5、nfluencingfactorsofpotassiumexcretionindistalandcollectingtubules:PotassiumconcentrationinECFAldosteroneDistalflowrateAcid-basebalance(3)PotassiumexcretionincolonThesameastheexcretioninkidney4.physiologicalfunctionofpotassiummaintaincellularmetabolismmaintai

6、ncellularrestingmembranepotentialregulatetheosmolarityandacid-basebalanceDisorderofpotassiummetabolismNormalserumpotassium:3.5-5.5mmol/LHypokalemiaHyperkalemia5.influencingfacterofpotassiumhomeostasisacidosisalkalosishypoxiaseruminsulinserumdamageofcells[K+]

7、ADS[K+]catabolismanabolismdistalflowratedistalflowrate1.Definition:Hypokalemiaisdefinedasadecreaseinserumpotassiumlevellessthan3.5mmol/L.Ⅱ.hypokalemia2.causes(1).intake↓(2).discharge↑①digestivetract②kidneys：③skinGI:vomiting;diarrhea;GastrointestinalsuctionSk

8、in:excessivesweatsfurosemidediureticlossesdiamoxdiureticphaseofARFrenal:primaryhyperaldosteronismlackofmagnesiumrenaltubularacidosisosmoticdiuresis(3).Abnormalitydistributionofpotassiummoveintoc