亲和吸附材料应用于血液灌流治疗外源性内毒素血症的安全性研究

Safety of affinity adsorption material used in hemoperfusion in treatment of exogenous endotoxemia

摘要:

目的 评估课题组研发的亲和吸附材料特异清除外源性内毒素的安全性。方法 15 只比格犬静脉输注内毒素（Sigma）复制内毒素血症模型，随机分为治疗组（n =10）和对照组（n =5），治疗组用课题组研发的一次性血液灌流器进行干预，对照组不用该灌流器。实验前后监测生命体征并于灌流开始、灌流60 及120 min 采集血液标本检测生化、血常规和凝血功能。结果 治疗组体温及呼吸在灌流后逐步下降，对照组则上升。灌流开始、灌流120 min 治疗组血小板（PLT）为（222.50±14.19）×109/L、（199.00±18.18）×109/L，对照组为（233.91±12.22）×109/L、（222.07±7.62）×109/L，两组比较，差异有统计学意义（P <0.05）；灌流开始、灌流120 min 治疗组白细胞（WBC）为（7.14±0.10）×109/L、（6.10±0.19）×109/L，对照组为（7.17±0.11）×109/L、（5.52±0.54）×109/L，两组比较，差异有统计学意义（P <0.05）。谷丙转氨酶（ALT）、谷草转氨酶（AST）、碱性磷酸酶（ALP）、总蛋白（TP）、球蛋白（GLO）治疗组灌流120 min与灌流开始比较，均差异有统计学意义（P <0.05），灌流120 min 均下降；对照组灌流120 min 与灌流开始比较，均差异有统计学意义（P <0.05），灌流120 min 均上升。尿素（Urea）、肌酐（Cr）、尿酸（UA）治疗组灌流120 min 后呈下降趋势，对照组则轻微上升。结论 该亲和吸附材料清除实验犬血液中的内毒素具有安全性。

Abstract:

Objective To evaluate the safety of affinity adsorption material for the removal of exogenous endotoxin. Methods Fifteen beagle dogs were randomly divided into treatment group (n = 10) and control group (n = 5) after intravenous infusion of endotoxin. The treatment group was treated with a blood perfusion apparatus developed by our team, while the control group did not use it. Vital signs were monitored before and after the experiment. Blood samples were collected to detect the biochemical indexes, blood routine and coagulation function at the beginning of perfusion, after perfusion for 60 and 120 min. Results After treatment, the body temperature and respiratory rate of the treatment group gradually decreased, while those of the control group increased. At the beginning of perfusion and 120 min of perfusion, PLT was (222.50 ± 14.19) × 109/L and (199.00 ± 18.18) × 109/L in the treatment group, and (233.91 ± 12.22) × 109/L and (222.07 ± 7.62) × 109/L in the control group, there were significant differences between the two groups (P < 0.05); WBC was (7.14 ± 0.10) × 109/L and (6.10 ± 0.19) × 109/L in the treatment group, and (7.17 ± 0.11) × 109/L and (5.52 ± 0.54) × 109/L in the control group, there were significant differences between the two groups (P < 0.05). Liver function indexes including ALT, AST, ALP, TP and GLO of the treatment group at 120 min of perfusion were significantly lower than those at the beginning of perfusion (P < 0.05), while the indexes of the control group at 120 min of perfusion were higher than those at the beginning of perfusion (P < 0.05). Renal function indices including urea, creatinine and uric acid also showed downward trends after perfusion for 120 min in the treatment group, while increased slightly in the control group. Conclusions It is safe to remove the endotoxin in the blood of the dog by affinity adsorption material.