山东大学：《病理生理学》课程教学资源（PPT课件讲稿）Chapter 04 酸碱平衡和酸碱平衡紊乱 Acid-base balance and acid-base disorders（主讲：薛冰）

求子 Shandong universit Chapter 4 Acid-base balance and acid-base disorders Department of Pathophysiology, the School of Medicine, Shandong University 薛冰

Chapter 4 Acid-base balance and acid-base disorders Department of Pathophysiology, the School of Medicine, Shandong University 薛冰

internal environment homeostasis Water balance /homeostasis acid-base balance electrolyte balance

internal environment homeostasis Water balance homeostasis acid-base balance electrolyte balance

Contents 1. Acid-Base Balance Acid-base biochemistry Regulation of pl H Laboratory tests 02. Simple acid-base disorders e Metabolic Acidosis e Respiratory acidosis o Metabolic Alkalosis Respiratory alkalosis e3. Mixed Acid-base Disturbance

1. Acid-Base Balance ⚫ Acid-base Biochemistry ⚫ Regulation of pH ⚫ Laboratory Tests 2. Simple Acid-base Disorders ⚫ Metabolic Acidosis ⚫ Respiratory Acidosis ⚫ Metabolic Alkalosis ⚫ Respiratory Alkalosis 3. Mixed Acid-base Disturbance Contents

Part l: Acid-base balance and its regulation The basic meaning of acid-base balance is the stable H+ in the body fluid

Part I: Acid-base balance and its regulation ⚫The basic meaning of acid-base balance is the stable [H+] in the body fluid

I Concept of acid and base acid: An acid is a h+ donor when it is dissolved in water After the loss of ht. it becomes a base HA(acd)→H+A(base) H2CO3→H++HcO3 H2sO4, H3 PO4 base: a base is a H+ acceptor, when it is dissolved in water. After the combining of H+,it becomes an acid ●A(ase)+H+→HA(acid) HCO3+H+→H2Co3 OH, HCO3, SO42, HPO42, NH

I、Concept of acid and base acid ： An acid is a H+ donor, when it is dissolved in water. After the loss of H+ , it becomes a base. HA (acid) → H+ + Aˉ(base) H2CO3 → H+ +HCO3ˉ H2SO4 , H3PO4 base： A base is a H+ acceptor, when it is dissolved in water. After the combining of H+ , it becomes an acid Aˉ(base)+ H+ → HA (acid) HCO3ˉ +H+ → H2CO3 OH- , HCO3 - , SO4 2- , HPO4 2- , NH3

I Sources of acid and base The main origin of acid and base is the intracellular metabolism (catabolism of protein, carbohydrate and fat) (D Source of acid volatile acid fixed acid

(I) Source of acid ❖ volatile acid ❖ fixed acid II、Sources of acid and base The main origin of acid and base is the intracellular metabolism (catabolism of protein, carbohydrate and fat)

☆1 volatile acid-—H2CO3 metabolism of protein, carbohydrate and fat co+O、HCO3→H+HCo3 CA daily production 300-40QL/d Reabsorption in kidney Excretion: lung RBC、 kidney tubulesepithelium, alveolar pithelial cell, gastric mucosa

daily production ：300-400L/d Excretion:lung ❖ 1.volatile acid—— H2CO3 CO2 ＋ H2O H2CO3 CA metabolism of protein, carbohydrate and fat H+ + HCO3 - Reabsorption in kidney RBC、kidney tubulesepithelium 、alveolar epithelial cell 、gastric mucosa

2. unvolatile acid(fixed acid): (50-100mmol/d) Uric acid, phosphoric acid(H3PO4)and sulfuric acid (H2S04)are the products in the metabolic process of proteins and nuclear acids Lactic acid and ketonic bodies(B-hydroxybutyric acid and acetoacetic acid) can be formed from the metabolic process of carbohydrate and fat as intermediate proaucts, when the oxygen supply is not sufficiency Exogenous acid( food and drug s Excretion through kidney

2. unvolatile acid (fixed acid) ： (50-100mmol/d) Uric acid, phosphoric acid (H3PO4) and sulfuric acid (H2SO4) are the products in the metabolic process of proteins and nuclear acids. Lactic acid and ketonic bodies (β-hydroxybutyric acid and acetoacetic acid) can be formed from the metabolic process of carbohydrate and fat as intermediate products, when the oxygen supply is not sufficiency. Exogenous acid(food and drug)： Excretion through kidney

(D) Sources of base e Origin of bases ● Endogenous: deamination ->NH3 Less than acid production o Exogenous input: vegetables, and fruits

(II) Sources of base Origin of bases ⚫ Endogenous： deamination―>NH3 Less than acid production ⚫ Exogenous input： vegetables, and fruits

I Regulation of acid-base balance

III、 Regulation of acid-base balance