本文關(guān)鍵詞：HB-H-6樹(shù)脂的血液相容性研究　出處：《天津醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： HB-H-6樹(shù)脂 血液灌流 血液相容性 白蛋白 PDMS

【摘要】：目的長(zhǎng)期以來(lái),研制具有良好血液相容性的生物材料一直是血液灌流技術(shù)的熱點(diǎn)和難點(diǎn)之一。近些年來(lái),臨床上多采用血漿置換結(jié)合血漿灌流對(duì)重度黃疸患者進(jìn)行救治,這雖然避免了血液中的有形成分與吸附材料的直接接觸,間接地提高了其血液相容性,卻大大加大了患者醫(yī)治的費(fèi)用,技術(shù)手段也相對(duì)復(fù)雜,這些局限性使其在臨床上的開(kāi)展遇到了一定的困難。為了節(jié)省成本,減輕患者的經(jīng)濟(jì)負(fù)擔(dān),本文通過(guò)研究白蛋白預(yù)充和PDMS包膜對(duì)HB-H-6樹(shù)脂血液相容性的影響,對(duì)比未經(jīng)處理的HB-H-6樹(shù)脂和經(jīng)過(guò)白蛋白預(yù)充的和PDMS包膜的三種HB-H-6樹(shù)脂的血液相容性,綜合性價(jià)比以及操作簡(jiǎn)易程度,期望能夠?qū)で笠环N廉價(jià)簡(jiǎn)便且改善效果良好的方法,為在臨床進(jìn)行直接全血灌流提供理論基礎(chǔ)。方法本實(shí)驗(yàn)分三部分進(jìn)行,第一部分通過(guò)體外動(dòng)靜態(tài)吸附實(shí)驗(yàn)來(lái)模擬吸附過(guò)程,分析全血和血漿共有的成分吸附前后變化情況,考察未經(jīng)過(guò)處理的HB-H-6樹(shù)脂對(duì)全血和血漿中電解質(zhì)、蛋白質(zhì)、補(bǔ)體等成分的吸附率,判斷直接全血灌流能否替代血漿灌流在臨床上使用;第二部分利用白蛋白預(yù)充樹(shù)脂和未經(jīng)處理樹(shù)脂對(duì)全血進(jìn)行吸附,分析全血吸附前后各成分變化情況,考察對(duì)比白蛋白預(yù)充后的樹(shù)脂與未經(jīng)處理的樹(shù)脂對(duì)全血中血細(xì)胞及血小板的影響。第三部分利用PDMS包膜HB-H-6樹(shù)脂,然后對(duì)全血進(jìn)行體外靜態(tài)吸附實(shí)驗(yàn),對(duì)比未經(jīng)處理的樹(shù)脂、白蛋白預(yù)充后的樹(shù)脂和PDMS包膜的樹(shù)脂三者的血液相容性優(yōu)劣性。結(jié)果第一部分的實(shí)驗(yàn)顯示:動(dòng)靜態(tài)吸附實(shí)驗(yàn)結(jié)果均表明,血漿組和全血組中的蛋白質(zhì)吸附前后無(wú)明顯變化(p0.05),補(bǔ)體C3、C4有一定的改變,但不明顯(p0.05),且均在正常值范圍內(nèi)。大部分電解質(zhì)均無(wú)明顯變化(p0.05),只有部分電解質(zhì)變化較明顯(p0.05)。從血漿組和全血組實(shí)驗(yàn)結(jié)果可以得出,未經(jīng)處理的HB-H-6樹(shù)脂對(duì)血漿和全血之間共有成分(電解質(zhì)、蛋白質(zhì),補(bǔ)體)的吸附效果基本保持一致。第二部分實(shí)驗(yàn)結(jié)果顯示:靜態(tài)實(shí)驗(yàn)顯示,未預(yù)充組在吸附2 h后白細(xì)胞、紅細(xì)胞、血小板分別下降了約11.14%、2.75%、28.9%。預(yù)充組結(jié)果明顯優(yōu)于未預(yù)充組,白細(xì)胞、紅細(xì)胞、血小板分別下降了約5.1%、1.8%、10.3%。動(dòng)態(tài)實(shí)驗(yàn)顯示,預(yù)充組在30min,60min,120min對(duì)體系中白細(xì)胞的吸附率(1.5%,3.2%,6.82%)、紅細(xì)胞的吸附率(1.36%,1.91%,3.55%;)、血小板的吸附率(5.2%,8%,12.2%)較未預(yù)充組對(duì)白細(xì)胞的吸附率(3.3%,7.8%,11.5%)、紅細(xì)胞的吸附率(2.2%,5.1%,7.7%)、血小板的吸附率(28.2%,44%,55.2%)均有明顯的改善。而且預(yù)充組在30min,60min,120min各個(gè)時(shí)間點(diǎn)進(jìn)吸附柱前到出吸附柱后樹(shù)脂對(duì)白細(xì)胞的吸附率(1.85%,1.25%,0.98%)、紅細(xì)胞的吸附率(1.38%,0.97%,0.51%)、血小板的吸附率(3.1%,5.4%,3%)較未預(yù)充組對(duì)進(jìn)吸附柱前后白細(xì)胞的吸附率(3.04%,6.2%,2.7%)、紅細(xì)胞的吸附率(2.3%,1.3%,0.97%)、血小板的吸附率(13.9%,24.3%,14.9%)也均有明顯的降低。第三部分實(shí)驗(yàn)結(jié)果顯示:經(jīng)過(guò)PDMS包膜的HB-H-6樹(shù)脂對(duì)全血中TP、ALB、GLO的平均吸附率分別為5.83%、10.54%、3.54%,白細(xì)胞、紅細(xì)胞、血小板的平均吸附率為2.94%、2.41%、3.81%。在三者當(dāng)中經(jīng)過(guò)PDMS包膜的HB-H-6樹(shù)脂血液相容性最好。結(jié)論1、未經(jīng)任何處理的HB-H-6樹(shù)脂的血液相容性比較差,雖然對(duì)全血和血漿中的共有成分吸附無(wú)差異,但對(duì)全血中的有形成分損害較嚴(yán)重,對(duì)血小板的損害尤為嚴(yán)重。2、經(jīng)過(guò)白蛋白預(yù)充的HB-H-6樹(shù)脂的血液相容性較未處理的有一些改進(jìn),而且操作簡(jiǎn)單,非常適合工業(yè)批量生產(chǎn),較容易實(shí)現(xiàn)。3、經(jīng)過(guò)PDMS包膜的HB-H-6樹(shù)脂的血液相容性較白蛋白預(yù)充的HB-H-6樹(shù)脂有了進(jìn)一步的改進(jìn),在三種處理方法中是最好的,但是其操作相對(duì)復(fù)雜一些,工業(yè)批量生產(chǎn)有一定的困難。4、本研究雖然為在臨床上直接進(jìn)行全血灌流提供了一定的理論基礎(chǔ),但利用HB-H-6樹(shù)脂直接進(jìn)行全血灌流究竟能否真正地取代血漿灌流結(jié)合血漿置換在臨床上投入使用,有待于進(jìn)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%.棰勫厖緇勭粨鏋滄槑鏄句紭?shù)簬鏈鍏吘l，

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