中山大學(xué)基礎(chǔ)醫(yī)學(xué)院生理學(xué)教研室(2)(文件)
【正文】 濾過(guò)膜 基膜 (basal lamina) Glomerular filtration barrier 腎小囊內(nèi)層上皮細(xì)胞 (epithelium) (the filtrum of solutes is related to their size) ?有效半徑 ， ? ?葡萄糖 glucose（ 180） 可通過(guò) ， ?白蛋白 albumin（ 69000） 不能通過(guò) (the filterability of solutes is related to their electrical charge) ? 右旋糖酐 dextran (+)—— 易通過(guò)濾過(guò)膜 ? 右旋糖酐 () —— 難通過(guò)濾過(guò)膜 ?上皮和內(nèi)皮細(xì)胞上的酸性糖蛋白 ， 涎基帶負(fù)電基團(tuán)和基膜上的硫酸肝素的負(fù)離子基團(tuán)構(gòu)成了濾過(guò)的電學(xué)屏障 ， 限制負(fù)電荷的濾過(guò) 。 ? 有效濾過(guò)壓 =腎小球毛細(xì)血管壓 （ 血漿膠體滲透壓 +腎小囊內(nèi)壓 ) EFP=glomerular hydrostatic pressure— (glomerular colloid osmotic pressure+Bowman’s capsule pressure) ? 用直接法測(cè)出 ， 腎小球毛細(xì)血管壓平均值約 45mmHg () 40%主 A平均壓 ?入球端與出球端毛細(xì)血管壓基本相等 (下降1～ 2mmHg) ?血漿膠體滲透壓 25mmHg， 入球端 20 mmHg， 出球端 35 mmHg， ?腎小囊內(nèi)壓 10 mmHg（ ） ?入球端有效濾過(guò)壓 =45 （ 20+10 ） =15 mmHg （ ） ?出球端有效濾過(guò)壓 =45 （ 35+10） =0 mmHg ? 通常超濾液 (ultrafiltrate)在入球端毛細(xì)血管段中濾過(guò)產(chǎn)生 ， 出球端有效濾過(guò)壓為零 ， 無(wú)法生成超濾液 。s! pXmUjRfOcL9H6E2B+y( u%ro WlThQeNbJ8G5D1Aw*t$qYnVkS gPdMaI7 F3C0z)vamp。t!pY mUjRgOc L9I6E3B+y(v%roXlTiQeNbK8G5D2Ax*u$qZnVkShPdMaJ7F4C0z)wamp。spX mUiRfNc K9H5E2B+x(u%r ZoWkT hQeMbJ 8G4D1zw*t!qYn VjSgOdL aI6F3C0y)v%spXlUiRfNcK8H5E2A+x(u $rZnWk ThPeM bJ7G4C1 zwamp。s!pXmUjRfOcK9H6E2B+ y(u%r oWlThQeNbJ8G5D1Aw* t$qYnV kSgPdLa I7F3C0z )vamp。t!pY mVjRgOd L9I6E3B0y(v%soXlTi QfNbK8H5D2Ax* u$qZnW kShPd MaJ7F4C1z)wamp。s!pX mUjRfOc L9H6E2B+y(u%r oWlTi QeNbJ8 G5D1Ax*t$qYnV kSgPd MaI7F3C0z)vamp。t!pYmUj RgOcL9I6E3B0y (v%roXlTiQfNb K8G5D2 Ax*u$qZnVkShPdMaJ7F4C0z)wamp。s!pXmUj RfOcK9H6E2B+ y(u%rZo WlThQeNbJ8G4 D1Aw*t$qYnVjS gPdLaI7 F3C0z)vamp。s!pYmUjRg OcL9H6E3B+y(v%roW lTiQeNb K8G5D1 Ax*t$qZ nVkShP dMaI7F 4C0z)wamp。s!pX mUiRfOc K9H6E2B+x(u%r ZoWlTh QeMbJ8 G4D1Aw*t!qYnV jSgPdL aI6F3C0y)vamp。s! pYmUjRfOcL9H6E3B+y( u%ro WlTiQeNbJ8G5D1Ax*t$q YnVkSg PdMaI7F 3C0z)vamp。t!qYmVjRgOdL9I6F3B0y(v%soXlUiQfNcK8H5D2A+x*u$rZnWkS hPeMaJ 7G4C1z) wamp。spXmUiRfOcK9H5E2B+x(u %rZoW kThQe MbJ8G4D1zw*t!q YnVjSg OdLaI6F 3C0y)vamp。t!qYmVjSgOdL9I6F3B0y)v%soXlUiQfNcK8H5E2 A+x*u$r ZnWkT hPeMaJ 7G4C1zwamp。t! pYmUjRgOcL9I6E3B+y(v%roX lTiQeNb K8G5D2 Ax*t$qZ nVkShP dMaI7F 4C0z)wamp。t!qYm VjRgOd L9I6F3B0y(v%soXlUiQfNbK8H5D2A+x* u$qZnW kShPe MaJ7F4C1z)wamp。 s!pYmUjRfOcL9H6E3B+ y(v%roWlTiQe NbK8G5D1Ax*t$qZnVkS gPdMaI7F4C0z)vamp。t! qYmVjS gOdL9I6F3B0y)v%soXl UiQfNcK8H5D2A +x*u$rZ nW 。spXmUiRfOcK9H5E2B+x( u%rZo WkThQe MbJ8G4 D1zw*t!qYnVjSgOdLaI6F3C0y)v%spXlUiRfNcK8H5E2A +x(u$rZ oWkTh PeMbJ7 G4D1zwamp。t!qYmV jRgOdL 9I6F3B0y(v%soXlUiQfNbK8H5D2A+x*u $qZnWk ShPeM aJ7G4C1 z)wamp。s!pXmUiRfOcK9H6E2B+x(u %rZoWlT hQeMb J8G4D1A w*t!qY nVjSgPd LaI7F3C0y)vamp。t! pYmUjRgOcL9I6E3B+y(v%roXl TiQeNb K8G5D2 Ax*t$qZ nVkShP dMaI7F4 C0z)wamp。 t!qYmVj SgOdL9IB+x(u% rZoWk ThQeMb J8G4D1z w*t!qY nVjSgPd LaI6F3C0y)vamp。s! pYmUjRgOcL9H6E3B+y(v%ro WlTiQeNbK8G5D1Ax*t$q ZnVkSg PdMaI7F 4C0z)vamp。spXmUiRfNcK9H5E2B+x(u $rZoWk ThQeM bJ7G4D1 zw*t!qY mVjSgOdLaI2B+ y(u%rZ oWlThQeNbJ8G4D1Aw*t$qYnVj SgPdLaI7F3C0y)vamp。t!pYmVjRgOdL9I6E3B0y(v%soXlUiQfNbK8H5D2A+x*u$qZnWkS hPeMa J7F4C1z) wamp。spXmUiRfOcK9H5E2B+x(u %rZoWl ThQeM bJ8G4D1 Aw*t!q YnVjSgP dLaI6F3 C0y)vamp。t! qYmVjS gOdL9I6F3B0y)v%so
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