医用导管抗菌涂层的研究进展  

Research Progress of Antibacterial Coating for Medical Catheter

作　　者：王瑞麟 赖长洪 何孟泽 何金枚 刘岚兰[1] 王松[1] 刘伟强[1,2,3] WANG Ruiin;LAI Changhong;HE Mengze;HE Jinmei;LIU Lanan;WANG Song;LIU Weiqiang(Biomechanics and Biotechnology Lab,Research Institute of Tsinghua University in Shenzhen,Guangdong Shenzhen 518057,China;Department of Mechanical Engineering,Tsinghua University,Beijing 100084,China;Tsinghua Shenzhen International Graduate School,Tsinghua University,Guangdong Shenzhen 518055,China)

机构地区：[1]深圳清华大学研究院生物医用材料及植入器械实验室,广东深圳518057 [2]清华大学机械工程系,北京100084 [3]清华大学深圳国际研究生院,广东深圳518055

出　　处：《表面技术》2024年第16期51-67,共17页Surface Technology

基　　金：广东省基础与应用基础研究基金(2020B1515120082);深圳市发展和改革委员会专项基金(XMHT20230115003)。

摘　　要：导管相关性感染(CRI)作为目前常见的医院获得性感染之一,导致死亡率和发病率增加,极大影响了医疗质量与患者健康,避免导管在植介入人体时产生感染已成为临床共性问题。细菌定植形成的生物膜是造成导管相关感染的主要原因,通过在医用导管表面设计功能性涂层来限制细菌定植及生物膜形成能有效避免感染。本文从防污改性、杀菌改性及防污-杀菌改性3个方面综述了近年来医用导管表面改性策略。防污改性一般通过将亲水的非离子型聚合物(如聚乙二醇、聚乙烯吡咯烷酮)以及两性离子聚合物制备在材料表面防止细菌及蛋白质黏附。杀菌改性根据机制可分为接触灭杀、释放灭杀和多机制联合灭杀,主要通过将杀菌剂接枝或负载在材料表面来赋予表面杀菌能力。防污-杀菌改性主要通过制备复合材料及聚合物刷、构建自适应表面及亲水聚合物负载杀菌剂等方式使表面同时具备防污及杀菌的能力。最后,在上述综述基础上对医用抗菌导管存在的问题进行了分析和展望,以期为制备应用于临床的高性能医用抗菌导管提供参考。Catheter is one of the widely used medical instruments at present,but its materials are mostly hydrophobic polymers,which have no antibacterial properties and are easy to make bacteria adhere to its surface and cause serious infection problems.Catheter-related infection(CRI),as one of the most common nosocomial infections,leads to mortality and morbidity,which greatly affects medical treatment and patients'health.Therefore,it has become a common clinical problem to avoid infection when a catheter is implanted into human body.Biofilm formed by bacterial colonization is the main cause of catheter-related infection.At present,researchers mainly prepare functional coatings on the surface of medical catheters to limit bacterial colonization and inhibit the formation of biofilms,so as to effectively avoid infection.In this paper,surface modification strategies of medical catheters in recent years were summarized,which were mainly carried out from three aspects:antifouling modification,sterilization modification and antifouling-sterilization modification.Antifouling modification was generally done by preparing hydrophilic nonionic polymers(e.g.,polyethylene glycol,polyvinylpyrrolidone)and zwitterionic polymers on the material surface.The surface of the catheter material was changed from hydrophobic to hydrophilic to improve the surface lubrication performance.At the same time,it could prevent the adhesion of bacteria,proteins and other substances and inhibit the formation of biofilms,but it had no bactericidal ability.Fungicidal modification was to endow the surface with bactericidal ability by grafting or loading fungicides on the surface of the catheter.According to the mechanism of fungicides,it could be divided into killing,releasing and killing or multi-mechanism combined killing.Killing meant that the surface could kill bacteria on the surface of the catheter,but it was likely to fail under complex conditions.Common fungicides were quaternary ammonium salt,chitosan and antibacterial peptide.Release killing meant t

关 键 词：导管相关性感染 医用导管 表面改性 抗菌策略 多机制抗菌 生物膜 

分 类 号：R318.6[医药卫生—生物医学工程]