肾小管酸化功能的临床研究

A Clinical Study of Renal Tubular Acid- ification

单以尿 pH 作为尿酸化的指标,引起很大争论。本文用尿 pH、HCO_3^-、可滴定酸(TA)、铵(NH_4^+)和同步血气分析为指标,观察正常人氯化铵试验前后、肾脏病人肾功能不全不同时期和肾小管酸中毒病人尿酸化功能的改变。认为尿 NH_4^+是比尿 pH 更为可靠的指标;在临床应将两者结合起来判断肾小管酸化功能。

There are some controversies about UpH as an unitary index for renal tu- bular acidification.The aim of this article is to find a more reliable estim- ate for urine acidification.Our studies were to determine UpH,HCO_3^-,TA, NH_4^+ and blood gas simultaneously during these following conditions:1. NH_4 Cl loading,the acid cxcretion function in normal subjects;2.acid excreting function of patients with renal insufficiency of normal,compensatory and uremic stages;3.urinary acidifing in- dex of patients with Type I renal tub- ular acidosis.Our estimations showed that NH_4^+ is more reliable than UpH as the index for renal tubular acidific- ation.The authors thought that the combination of NH_4^+ and UpH index- es together is necessary to evaluate the urine acidification.