中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2009年
3期
179-182
,共4页
田爽%李涛%骆力群%杜智
田爽%李濤%駱力群%杜智
전상%리도%락력군%두지
内毒素%炎症细胞因子%内毒素血症%血浆灌流%吸附
內毒素%炎癥細胞因子%內毒素血癥%血漿灌流%吸附
내독소%염증세포인자%내독소혈증%혈장관류%흡부
endotoxin%proinflammatory cytokine%endotoxemia%hemoperfusion%adsorption
目的 通过体外实验探讨使用HB-H-7树脂吸附血浆内毒素及炎症细胞因子的有效性和安全性.方法 静态吸附实验:树脂与内毒素阳性患者血浆按1∶10比例混合,置37 ℃恒温水浴振荡2 h.动态吸附实验:将内毒素阳性患者血浆经过装有树脂的自制灌流器中灌流2 h.测定灌流前后血浆内毒素、炎症细胞因子、蛋白质和电解质浓度,计算吸附率.比较静态与动态不同吸附方式以及不同温度血浆灌流前后(30、60、120 min)血浆内毒素浓度的变化,并计算吸附率.结果 静态吸附实验中,用HB-H-7树脂吸附后,血浆内毒素和炎症细胞因子含量均显著降低(P均<0.05),内毒素、肿瘤坏死因子-α、白细胞介素-1、6、8的吸附率分别为99.2%、55.0%、57.0%、75.0%、42.0%;而对蛋白质影响较小(P均<0.05);对电解质无明显影响(P均>0.05).动态与静态血浆内毒素吸附率比较差异无统计学意义(99.8%比99.1%,P>0.05),37 ℃与25 ℃下血浆内毒素吸附率比较差异亦无统计学意义(99.8%比99.9%,P>0.05).结论 HB-H-7树脂对内毒素及炎症细胞因子有明显吸附效果,对蛋白质影响较小,对电解质无明显影响.
目的 通過體外實驗探討使用HB-H-7樹脂吸附血漿內毒素及炎癥細胞因子的有效性和安全性.方法 靜態吸附實驗:樹脂與內毒素暘性患者血漿按1∶10比例混閤,置37 ℃恆溫水浴振盪2 h.動態吸附實驗:將內毒素暘性患者血漿經過裝有樹脂的自製灌流器中灌流2 h.測定灌流前後血漿內毒素、炎癥細胞因子、蛋白質和電解質濃度,計算吸附率.比較靜態與動態不同吸附方式以及不同溫度血漿灌流前後(30、60、120 min)血漿內毒素濃度的變化,併計算吸附率.結果 靜態吸附實驗中,用HB-H-7樹脂吸附後,血漿內毒素和炎癥細胞因子含量均顯著降低(P均<0.05),內毒素、腫瘤壞死因子-α、白細胞介素-1、6、8的吸附率分彆為99.2%、55.0%、57.0%、75.0%、42.0%;而對蛋白質影響較小(P均<0.05);對電解質無明顯影響(P均>0.05).動態與靜態血漿內毒素吸附率比較差異無統計學意義(99.8%比99.1%,P>0.05),37 ℃與25 ℃下血漿內毒素吸附率比較差異亦無統計學意義(99.8%比99.9%,P>0.05).結論 HB-H-7樹脂對內毒素及炎癥細胞因子有明顯吸附效果,對蛋白質影響較小,對電解質無明顯影響.
목적 통과체외실험탐토사용HB-H-7수지흡부혈장내독소급염증세포인자적유효성화안전성.방법 정태흡부실험:수지여내독소양성환자혈장안1∶10비례혼합,치37 ℃항온수욕진탕2 h.동태흡부실험:장내독소양성환자혈장경과장유수지적자제관류기중관류2 h.측정관류전후혈장내독소、염증세포인자、단백질화전해질농도,계산흡부솔.비교정태여동태불동흡부방식이급불동온도혈장관류전후(30、60、120 min)혈장내독소농도적변화,병계산흡부솔.결과 정태흡부실험중,용HB-H-7수지흡부후,혈장내독소화염증세포인자함량균현저강저(P균<0.05),내독소、종류배사인자-α、백세포개소-1、6、8적흡부솔분별위99.2%、55.0%、57.0%、75.0%、42.0%;이대단백질영향교소(P균<0.05);대전해질무명현영향(P균>0.05).동태여정태혈장내독소흡부솔비교차이무통계학의의(99.8%비99.1%,P>0.05),37 ℃여25 ℃하혈장내독소흡부솔비교차이역무통계학의의(99.8%비99.9%,P>0.05).결론 HB-H-7수지대내독소급염증세포인자유명현흡부효과,대단백질영향교소,대전해질무명현영향.
Objective To study the efficacy and safety of adsorption of endotoxin and proinflammatory cytokines with HB-H-7 resin in vitro. Methods Static adsorption experiment: HB-H-7 resin was added into plasma of endotoxin-positive patients according to the ratio of 1∶10. Then, they were put in a constant temperature water bath oscillator, and oscillated for 2 hours. Before and after the experiment, plasma endotoxin, proinflammatory cytokines, protein and electrolytes were detected, and the rate of 2-hour absorption was calculated. The experiment was repeated 10 times. Dynamic adsorption experiment: 5 ml resin was put into a self-made perfusion unit. Endotoxin-positive patients plasma (50 ml) was perfused for 2 hours. The flow rate of plasma was controlled at 4 ml/min with the infusion pump, and the plasma endotoxin was determined at 0, 30, 60 and 120 minutes after plasma hemoperfusion, and the absorption rates were calculated. The results were compared with static adsorption. The influence of temperature during adsorption was determined as follows. Perfusion method was similar with dynamic adsorption experiment. The perfusion units were either placed in a 37 ℃ water path or 25℃ (room temperature). Then, the plasma endotoxin was measured 2 hours after plasma perfusion, and the absorption rates were calculated. Results In static adsorption experiment, the plasma endotoxin and proinflammatory cytokines were significantly lower after adsorption with HB-H-7 resin adsorption (all P<0.05). The adsorption rates of endotoxin, tumor necrosis factor-α and interleukin-1, 6, 8 were 99.2%, 55.0%, 57.0%, 75.0%, 42.0%, respectively. Changes in protein were small (all P<0.05), and there was no significant change in plasma electrolytes (all P>0.05). Dynamic adsorption rate was higher than that of static, but the differences were not significant (99.8% vs. 99.1%, P>0.05). There was no statistically significant difference between difference in temperature (37 ℃ vs. 25 ℃, 99.8% vs. 99.9%, P>0.05). Conclusion HB-H-7 resin effectively adsorbes endotoxin and proinflammatory cytokines in vitro. Its adsorption rate for protien is lower, and it has no obvious effects on electrolytes.
