钾代谢障碍 酸碱平衡紊乱幻灯片

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

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

3、ion(1)PotassiumtranscellulartransferPump-leakmechanismfactors:PotassiumconcentrationinECFAcid-basebalanceInsulinCatecholamineOsmolarityExerciseTotalbodypotassium(2).RenalregulationforpotassiumexcretionGlomerularfiltrationReabsorptionbytheproximaltubuleandth

4、eloopofHenleRegulationofpotassiumexcretioninthedistalandcollectingtubulesSodium-potassiumATPasePermeabilityofluminalmembraneforpotassiumReabsorptionincollectingtubulesHydrogen-potassiumATPase-protonpumpMechanismofpotassiumexcretionindistalandcollectingtubul

5、es:Influencingfactorsofpotassiumexcretionindistalandcollectingtubules:PotassiumconcentrationinECFAldosteroneDistalflowrateAcid-basebalance(3)PotassiumexcretionincolonThesameastheexcretioninkidney4.physiologicalfunctionofpotassiummaintaincellularmetabolismma

6、intaincellularrestingmembranepotentialregulatetheosmolarityandacid-basebalanceDisorderofpotassiummetabolismNormalserumpotassium:3.5-5.5mmol/LHypokalemiaHyperkalemia5.influencingfacterofpotassiumhomeostasisacidosisalkalosishypoxiaseruminsulinserumdamageofcel

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

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