亲和吸附材料应用于血液灌流治疗外源性内毒素血症的安全性研究  

Safety of affinity adsorption material used in hemoperfusion in treatment of exogenous endotoxemia

作　　者：向勇平 崔辉[2] 于杰 刘丹[2] 刘理金 周立冬 杨建明 刘爱兵[2] Yong-ping Xiang;Hui Cui;Jie Yu;Dan Liu;Li-jin Liu;Li-dong Zhou;Jian-ming Yang;Ai-bing Liu(Postgraduate Traning Base in General Hospital of Chinese People’s Armed Police Forces, Jinzhou Medical University, Beijing 100039, China;Medical Experimental Center, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China;Tianjin Yangquan Medical Instrument Limited Company, Tianjin 300350, China;Beijing Key Laboratory of Disaster Rescue Medicine, Beijing 100039, China;Tianjin Port Hospital, Tianjin 300350, China)

机构地区：[1]锦州医科大学武警总医院研究生培养基地,北京100039 [2]武警总医院医学实验中心,北京100039 [3]天津市阳泉医疗器械有限公司,天津300350 [4]灾害救援医学北京市重点实验室,北京100039 [5]天津市港口医院,天津300350

出　　处：《中国现代医学杂志》2018年第1期6-10,共5页China Journal of Modern Medicine

基　　金：国家高技术研究发展计划(No:2015AA033904)

摘　　要：目的评估课题组研发的亲和吸附材料特异清除外源性内毒素的安全性。方法 15只比格犬静脉输注内毒素(Sigma)复制内毒素血症模型,随机分为治疗组(n=10)和对照组(n=5),治疗组用课题组研发的一次性血液灌流器进行干预,对照组不用该灌流器。实验前后监测生命体征并于灌流开始、灌流60及120 min采集血液标本检测生化、血常规和凝血功能。结果治疗组体温及呼吸在灌流后逐步下降,对照组则上升。灌流开始、灌流120 min治疗组血小板(PLT)为(222.50±14.19)×10~9/L、(199.00±18.18)×10~9/L,对照组为(233.91±12.22)×10~9/L、(222.07±7.62)×10~9/L,两组比较,差异有统计学意义(P<0.05);灌流开始、灌流120 min治疗组白细胞(WBC)为(7.14±0.10)×10~9/L、(6.10±0.19)×10~9/L,对照组为(7.17±0.11)×10~9/L、(5.52±0.54)×10~9/L,两组比较,差异有统计学意义(P<0.05)。谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总蛋白(TP)、球蛋白(GLO)治疗组灌流120 min与灌流开始比较,均差异有统计学意义(P<0.05),灌流120 min均下降;对照组灌流120 min与灌流开始比较,均差异有统计学意义(P<0.05),灌流120 min均上升。尿素(Urea)、肌酐(Cr)、尿酸(UA)治疗组灌流120 min后呈下降趋势,对照组则轻微上升。结论该亲和吸附材料清除实验犬血液中的内毒素具有安全性。Objective To evaluate the safety of affinity adsorption material for the removal of exogenous endotoxin.Methods Fifteen beagle dogs were randomly divided into treatment group(n=10)and control group(n=5)after intravenous infusion of endotoxin.The treatment group was treated with a blood perfusion apparatus developed by our team,while the control group did not use it.Vital signs were monitored before and after the experiment.Blood samples were collected to detect the biochemical indexes,blood routine and coagulation function at the beginning of perfusion,after perfusion for60and120min.Results After treatment,the body temperatureand respiratory rate of the treatment group gradually decreased,while those of the control group increased.At the beginning of perfusion and120min of perfusion,PLT was(222.50±14.19)×109/L and(199.00±18.18)×109/L in the treatment group,and(233.91±12.22)×109/L and(222.07±7.62)×109/L in the control group,there were significant differences between the two groups(P<0.05);WBC was(7.14±0.10)×109/L and(6.10±0.19)×109/L in the treatment group,and(7.17±0.11)×109/L and(5.52±0.54)×109/L in the control group,there were significant differences between the two groups(P<0.05).Liver function indexes including ALT,AST,ALP,TP and GLO of the treatment group at120min of perfusion were significantly lower than those at the beginning of perfusion(P<0.05),while the indexes of the control group at120min of perfusion were higher than those at the beginning of perfusion(P<0.05).Renal function indices including urea,creatinine and uric acid also showed downward trends after perfusion for120min in the treatment group,while increased slightly in the control group.Conclusions It is safe to remove the endotoxin in the blood of the dog by affinity adsorption material.

关 键 词：亲和吸附材料 血液灌流 比格犬 内毒素血症 安全性 

分 类 号：R-332[医药卫生]