HB-H-6树脂的血液相容性研究

发布时间：2018-01-16 11:18

  本文关键词：HB-H-6树脂的血液相容性研究　出处：《天津医科大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： HB-H-6树脂 血液灌流 血液相容性 白蛋白 PDMS

【摘要】：目的长期以来,研制具有良好血液相容性的生物材料一直是血液灌流技术的热点和难点之一。近些年来,临床上多采用血浆置换结合血浆灌流对重度黄疸患者进行救治,这虽然避免了血液中的有形成分与吸附材料的直接接触,间接地提高了其血液相容性,却大大加大了患者医治的费用,技术手段也相对复杂,这些局限性使其在临床上的开展遇到了一定的困难。为了节省成本,减轻患者的经济负担,本文通过研究白蛋白预充和PDMS包膜对HB-H-6树脂血液相容性的影响,对比未经处理的HB-H-6树脂和经过白蛋白预充的和PDMS包膜的三种HB-H-6树脂的血液相容性,综合性价比以及操作简易程度,期望能够寻求一种廉价简便且改善效果良好的方法,为在临床进行直接全血灌流提供理论基础。方法本实验分三部分进行,第一部分通过体外动静态吸附实验来模拟吸附过程,分析全血和血浆共有的成分吸附前后变化情况,考察未经过处理的HB-H-6树脂对全血和血浆中电解质、蛋白质、补体等成分的吸附率,判断直接全血灌流能否替代血浆灌流在临床上使用;第二部分利用白蛋白预充树脂和未经处理树脂对全血进行吸附,分析全血吸附前后各成分变化情况,考察对比白蛋白预充后的树脂与未经处理的树脂对全血中血细胞及血小板的影响。第三部分利用PDMS包膜HB-H-6树脂,然后对全血进行体外静态吸附实验,对比未经处理的树脂、白蛋白预充后的树脂和PDMS包膜的树脂三者的血液相容性优劣性。结果第一部分的实验显示:动静态吸附实验结果均表明,血浆组和全血组中的蛋白质吸附前后无明显变化(p0.05),补体C3、C4有一定的改变,但不明显(p0.05),且均在正常值范围内。大部分电解质均无明显变化(p0.05),只有部分电解质变化较明显(p0.05)。从血浆组和全血组实验结果可以得出,未经处理的HB-H-6树脂对血浆和全血之间共有成分(电解质、蛋白质,补体)的吸附效果基本保持一致。第二部分实验结果显示:静态实验显示,未预充组在吸附2 h后白细胞、红细胞、血小板分别下降了约11.14%、2.75%、28.9%。预充组结果明显优于未预充组,白细胞、红细胞、血小板分别下降了约5.1%、1.8%、10.3%。动态实验显示,预充组在30min,60min,120min对体系中白细胞的吸附率(1.5%,3.2%,6.82%)、红细胞的吸附率(1.36%,1.91%,3.55%;)、血小板的吸附率(5.2%,8%,12.2%)较未预充组对白细胞的吸附率(3.3%,7.8%,11.5%)、红细胞的吸附率(2.2%,5.1%,7.7%)、血小板的吸附率(28.2%,44%,55.2%)均有明显的改善。而且预充组在30min,60min,120min各个时间点进吸附柱前到出吸附柱后树脂对白细胞的吸附率(1.85%,1.25%,0.98%)、红细胞的吸附率(1.38%,0.97%,0.51%)、血小板的吸附率(3.1%,5.4%,3%)较未预充组对进吸附柱前后白细胞的吸附率(3.04%,6.2%,2.7%)、红细胞的吸附率(2.3%,1.3%,0.97%)、血小板的吸附率(13.9%,24.3%,14.9%)也均有明显的降低。第三部分实验结果显示:经过PDMS包膜的HB-H-6树脂对全血中TP、ALB、GLO的平均吸附率分别为5.83%、10.54%、3.54%,白细胞、红细胞、血小板的平均吸附率为2.94%、2.41%、3.81%。在三者当中经过PDMS包膜的HB-H-6树脂血液相容性最好。结论1、未经任何处理的HB-H-6树脂的血液相容性比较差,虽然对全血和血浆中的共有成分吸附无差异,但对全血中的有形成分损害较严重,对血小板的损害尤为严重。2、经过白蛋白预充的HB-H-6树脂的血液相容性较未处理的有一些改进,而且操作简单,非常适合工业批量生产,较容易实现。3、经过PDMS包膜的HB-H-6树脂的血液相容性较白蛋白预充的HB-H-6树脂有了进一步的改进,在三种处理方法中是最好的,但是其操作相对复杂一些,工业批量生产有一定的困难。4、本研究虽然为在临床上直接进行全血灌流提供了一定的理论基础,但利用HB-H-6树脂直接进行全血灌流究竟能否真正地取代血浆灌流结合血浆置换在临床上投入使用,有待于进一步研究。
[Abstract]:Objective to develop a long time, has good blood compatibility of biomaterials has been one of the hot and difficult hemoperfusion technology. In recent years, the clinical use of plasmapheresis combined with plasma perfusion for treatment of patients with severe jaundice, although this is avoided in the blood have formed direct contact and indirect absorption material. To improve the blood compatibility, but greatly increased the patient treatment costs, technology is relatively complex, these limitations in the clinical development has encountered some difficulties. In order to save costs, reduce the economic burden of the patients, the compatibility effect on HB-H-6 resin by studying the pre charge and blood albumin PDMS the envelope, contrast without HB-H-6 resin treatment and after three kinds of HB-H-6 resins and PDMS albumin priming coating blood compatibility, ease of operation and comprehensive cost, period Hope to seek a simple and inexpensive method to improve good effect, to direct blood perfusion and provide a theoretical basis in clinic. Methods the experiment was divided into three parts, the first part through static and dynamic adsorption experiments in vitro to simulate the adsorption process, analyze the changes before and after adsorption components of blood and plasma were investigated, without HB-H-6 resin treatment of electrolyte, blood and plasma protein adsorption, complement and other components of the direct judgment rate, whole blood perfusion can replace plasma perfusion in clinical use; the second part using albumin pre filled resin and untreated resin adsorption on blood, analysis of all components of blood changes before and after adsorption of albumin contrast resin after the pre charge and untreated resin for whole blood cell and platelet effects. The third part using PDMS coated HB-H-6 resin, then the whole blood The static adsorption experiment in vitro, compared with untreated resin, resin and PDMS resin coated albumin pre charge after the three blood compatibility advantages. The results of the first part: the static and dynamic adsorption experiments showed that the experimental results showed that the plasma group and blood group protein adsorption had no significant change before and after (P0.05) complement, C3, C4 have a certain change, but not obvious (P0.05), and were in the normal range. Most of the electrolyte had no significant changes (P0.05), the only part of the electrolyte significantly (P0.05). The plasma group and blood group from the experimental results, without the HB-H-6 resin treatment of plasma and blood components (total protein, electrolyte, complement) adsorption effect is consistent. The second part experimental results show that the static experiment showed that no priming group in 2 h after the adsorption of white blood cells, red blood cells, platelets were decreased by about 11.14%, 2.75%,28.9%.棰勫厖缁勭粨鏋滄槑鏄句紭浜庢湭棰勫厖缁，

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