中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2008年
1期
170-174
,共5页
曲娟%李庭红%张静%陆伟%张政朴
麯娟%李庭紅%張靜%陸偉%張政樸
곡연%리정홍%장정%륙위%장정박
壳聚糖%重型肝炎%胆红素%细胞因子
殼聚糖%重型肝炎%膽紅素%細胞因子
각취당%중형간염%담홍소%세포인자
背景:人工肝治疗重型肝炎要达到有效的治疗效果,必须具有吸附性能特异性强、吸附率高、血液相容性好等特性的吸附材料.目的:观察8种新型吸附剂对重型肝炎患者血浆中的胆红素和细胞因子的吸附性能.设计:对比观察.单位:天津医科大学研究生院,天津海河医院,天津市第三中心医院和南开大学高分子化学研究所.对象:全部血浆来自2004-11/2005-11天津市第三中心医院住院的重型肝炎患者30例.患者对治疗和实验均知情同意且该实验经医院伦理委员会批准.将上述患者随机分为2组:实验1组10例和实验2组20例.两组总胆红素水平分别为(377.3±147.5),(327.6± 140.1)μmol/L.方法:①吸附剂:实验选用的壳聚糖由山东青岛利中壳聚糖厂生产,相对分子质量97 000,脱乙酰度85%.1#～3#吸附剂为以质量浓度1%,3%,5%相对分子量为600的聚乙二醇为致孔剂制备的壳聚糖,4#为胺基化壳聚糖,5#为苯乙烯/二乙烯苯聚合物,6#为后交连苯乙烯/二乙烯苯聚合物,7#为壳聚糖-苯乙烯/二乙烯苯聚合物,8#为壳聚糖-后交连苯乙烯/二乙烯苯聚合物.②指标检测:第一步:收集实验1组重型肝炎患者的血浆各 3 mL,以8种不同的吸附剂各1 mL进行吸附.采用钒酸盐氧化法测定吸附前后血浆中总胆红素、直接胆红素、间接胆红素浓度,计算血浆吸附率,筛选出两种吸附率较高的吸附剂.第二步:用以上筛选出吸附率较好的两种吸附剂各1 mL对实验组患者血浆(各3 mL)进行胆红素和白细胞介素6、肿瘤坏死因子α的吸附实验,后两者的测定采用ELISA法.主要观察指标:吸附前后血浆中胆红素的浓度和细胞因子水平.结果:①第一步实验显示4#和5#吸附剂吸附后患者血浆总胆红素、直接胆红素、间接胆红素浓度明显降低,差异有显著性意义(P < 0.01);其余6种吸附剂吸附前后比较,差异无显著性意义(P > 0.05).②第二步实验显示,4#和5#吸附剂吸附后实验2组患者血浆总胆红素、直接胆红素、间接胆红素浓度和白细胞介素6 和肿瘤坏死因子α水平均明显下降,差异有显著性意义(P < 0.01).4#吸附剂吸附后前述5项指标低于5#吸附剂,差异有显著性意义(P < 0.01).结论:胺基化壳聚糖体外吸附重型肝炎患者血浆中胆红素、细胞因子效果有明显优势.
揹景:人工肝治療重型肝炎要達到有效的治療效果,必鬚具有吸附性能特異性彊、吸附率高、血液相容性好等特性的吸附材料.目的:觀察8種新型吸附劑對重型肝炎患者血漿中的膽紅素和細胞因子的吸附性能.設計:對比觀察.單位:天津醫科大學研究生院,天津海河醫院,天津市第三中心醫院和南開大學高分子化學研究所.對象:全部血漿來自2004-11/2005-11天津市第三中心醫院住院的重型肝炎患者30例.患者對治療和實驗均知情同意且該實驗經醫院倫理委員會批準.將上述患者隨機分為2組:實驗1組10例和實驗2組20例.兩組總膽紅素水平分彆為(377.3±147.5),(327.6± 140.1)μmol/L.方法:①吸附劑:實驗選用的殼聚糖由山東青島利中殼聚糖廠生產,相對分子質量97 000,脫乙酰度85%.1#～3#吸附劑為以質量濃度1%,3%,5%相對分子量為600的聚乙二醇為緻孔劑製備的殼聚糖,4#為胺基化殼聚糖,5#為苯乙烯/二乙烯苯聚閤物,6#為後交連苯乙烯/二乙烯苯聚閤物,7#為殼聚糖-苯乙烯/二乙烯苯聚閤物,8#為殼聚糖-後交連苯乙烯/二乙烯苯聚閤物.②指標檢測:第一步:收集實驗1組重型肝炎患者的血漿各 3 mL,以8種不同的吸附劑各1 mL進行吸附.採用釩痠鹽氧化法測定吸附前後血漿中總膽紅素、直接膽紅素、間接膽紅素濃度,計算血漿吸附率,篩選齣兩種吸附率較高的吸附劑.第二步:用以上篩選齣吸附率較好的兩種吸附劑各1 mL對實驗組患者血漿(各3 mL)進行膽紅素和白細胞介素6、腫瘤壞死因子α的吸附實驗,後兩者的測定採用ELISA法.主要觀察指標:吸附前後血漿中膽紅素的濃度和細胞因子水平.結果:①第一步實驗顯示4#和5#吸附劑吸附後患者血漿總膽紅素、直接膽紅素、間接膽紅素濃度明顯降低,差異有顯著性意義(P < 0.01);其餘6種吸附劑吸附前後比較,差異無顯著性意義(P > 0.05).②第二步實驗顯示,4#和5#吸附劑吸附後實驗2組患者血漿總膽紅素、直接膽紅素、間接膽紅素濃度和白細胞介素6 和腫瘤壞死因子α水平均明顯下降,差異有顯著性意義(P < 0.01).4#吸附劑吸附後前述5項指標低于5#吸附劑,差異有顯著性意義(P < 0.01).結論:胺基化殼聚糖體外吸附重型肝炎患者血漿中膽紅素、細胞因子效果有明顯優勢.
배경:인공간치료중형간염요체도유효적치료효과,필수구유흡부성능특이성강、흡부솔고、혈액상용성호등특성적흡부재료.목적:관찰8충신형흡부제대중형간염환자혈장중적담홍소화세포인자적흡부성능.설계:대비관찰.단위:천진의과대학연구생원,천진해하의원,천진시제삼중심의원화남개대학고분자화학연구소.대상:전부혈장래자2004-11/2005-11천진시제삼중심의원주원적중형간염환자30례.환자대치료화실험균지정동의차해실험경의원윤리위원회비준.장상술환자수궤분위2조:실험1조10례화실험2조20례.량조총담홍소수평분별위(377.3±147.5),(327.6± 140.1)μmol/L.방법:①흡부제:실험선용적각취당유산동청도리중각취당엄생산,상대분자질량97 000,탈을선도85%.1#～3#흡부제위이질량농도1%,3%,5%상대분자량위600적취을이순위치공제제비적각취당,4#위알기화각취당,5#위분을희/이을희분취합물,6#위후교련분을희/이을희분취합물,7#위각취당-분을희/이을희분취합물,8#위각취당-후교련분을희/이을희분취합물.②지표검측:제일보:수집실험1조중형간염환자적혈장각 3 mL,이8충불동적흡부제각1 mL진행흡부.채용범산염양화법측정흡부전후혈장중총담홍소、직접담홍소、간접담홍소농도,계산혈장흡부솔,사선출량충흡부솔교고적흡부제.제이보:용이상사선출흡부솔교호적량충흡부제각1 mL대실험조환자혈장(각3 mL)진행담홍소화백세포개소6、종류배사인자α적흡부실험,후량자적측정채용ELISA법.주요관찰지표:흡부전후혈장중담홍소적농도화세포인자수평.결과:①제일보실험현시4#화5#흡부제흡부후환자혈장총담홍소、직접담홍소、간접담홍소농도명현강저,차이유현저성의의(P < 0.01);기여6충흡부제흡부전후비교,차이무현저성의의(P > 0.05).②제이보실험현시,4#화5#흡부제흡부후실험2조환자혈장총담홍소、직접담홍소、간접담홍소농도화백세포개소6 화종류배사인자α수평균명현하강,차이유현저성의의(P < 0.01).4#흡부제흡부후전술5항지표저우5#흡부제,차이유현저성의의(P < 0.01).결론:알기화각취당체외흡부중형간염환자혈장중담홍소、세포인자효과유명현우세.
BACKGROUND: The effective therapy of artificial liver for severe hepatitis needs an absorbing material which possesses strong adsorptive property, high adsorption rate and good blood compatibility.OBJECTIVE: To study the adsorptive property of eight novel adsorbents for plasma bilirubin and cytokines in severe hepatitis patients. DESIGN: A controlled observation.SETTINGS: Graduate School of Tianjin Medical University, Tianjin Haihe Hospital, Tianjin Third Central Hospital and the Institute of Polymer Chemistry in Nankai University.PARTICIPANTS: All plasma was collected from 30 severe hepatitis patients hospitalized in Tianjin Third Central Hospital from November 2004 to November 2005. Informed consent was obtained from each patients. This experiment was approved by the hospital ethical committee. All the patients were divided into two groups at random: group 1 (n=10) and group 2 (n=20). The level of total bilirubin (TBiL) before therapy in two groups was (377.3±147.5) μmol/L and (327.6± 140.1) μmol/L, respectively.METHODS: ①Adsorbents: Chitosan (Qingdao Lizhong Chitosan Factory, Shandong) with relative molecular weight 97 000 and de-acetyl grade 85%; Adsorbents No.1-3 were prepared by using 1%, 3%, 5% polyethyleneglycol (relative molecular weight 600) as porogenic agent. Adsorbent No.4 was aminated crosslinked chitosan microspheres; Adsorbent No.5 was divinyl-benzene crosslinked macroporous polystyrene microspheres; Adsorbent No.6 was post-crosslinked macroporous divinyl-benzene styrene copolymer microspheres; Adsorbents No.7 and 8 were chitosan wrapped adsorbent No.5 and 6.②Detection: Step 1: 3 mL plasma collected from each severe hepatitis patient in group 1 was absorbed with 1 mL of 8 kinds of adsorbents. Levels of plasma TBiL, direct bilirubin (DBiL) and indirect bilirubin (IBiL) before and after adsorption were determined by using the vanadate oxidation method to analyze the average adsorption capacity so as to screen the adsorbents with the better adsorptive properties. Step 2: 3 mL plasma collected from each severe hepatitis patient in group 2 was absorbed with 1 mL of two adsorbents selected from the step 1. The levels of bilirubin, interleukin-6 and tumor necrosis factor-α before and after the adsorption were analyzed by ELISA method.MAIN OUTCOME MEASURES: The levels of bilirubin and cytokines before and after the adsorption were determined.RESULTS: ①The data in the first step experiment showed that after No.4 and No.5 adsorbents were used, the level of plasma TBiL, DBiL and IBiL were significantly decreased (P < 0.01); no differences were found for other six kinds of adsorbents (P > 0.05).②The data in the second step experiment showed that the average levels of plasma TBiL, DBiL, IBiL, interleukin-6 and tumor necrosis factor-α were remarkably reduced after using adsorbents No.4 and No.5 (P < 0.01). Compared with adsorbent No.5, there were significant decrements for adsorbents No.4 (P < 0.01).CONCLUSION: Aminated chitosan microsphere has significant effects on adsorbing bilirubin and cytokines in plasma of severe hepatitis patients in vitro.
