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利尿药的作用机理各种利尿药作用的共同基础是增加肾小球的滤过及/或抑制肾小管重吸收钠的能力。滤过减少时重吸收亦减少,反之亦然。但肾小管重吸收可不受肾小球滤过的影响,而单独发生变化,其原理尚未完全阐明,最近的研究提示近曲小管可能起主要作用。肾小管重吸收发生在四个部位。第一部位在近曲小管,在此处重吸收的钠占滤过钠的60～70％;第二部位在髓襻的升枝,占15～20％;第三、四部位在远曲小管,占6～8％。最近研究证明在第一部位的钠重吸收增加是水肿患者水盐潴留的最重要因素。乙酰唑胺(Diamox)通过抑制近曲小管碳酸酐酶而起作用,但利尿作用弱。利尿磺胺对该部位有一定
The Mechanism of Diuretics The common basis for the role of various diuretics is to increase the glomerular filtration and / or to inhibit renal tubular reabsorption of sodium. Reduce the reabsorption when the filtration is also reduced, and vice versa. However, renal tubular reabsorption can not be affected by glomerular filtration, and changes alone, the principle has not been fully elucidated, recent studies suggest that proximal tubule may play a major role. Tubular reabsorption occurs in four parts. The first part of the proximal convoluted tubules, where reabsorption of sodium accounted for sodium filtration of 60 to 70%; the second part of the medullary riparian branches, accounting for 15 to 20%; the third and fourth parts in the distal convoluted tubules , Accounting for 6 ~ 8%. Recent studies show that the first part of the increase in sodium reabsorption is the most important factor in water and salt retention in patients with edema. Diamox acts by inhibiting proximal tubule carbonic anhydrase, but has a weak diuretic effect. Diuretic sulfa on the part of a certain