血液净化膜材和抗凝剂对凝血过程中接触活化的影响

Effect of Blood Purification Materials and Anticoagulants on the Contact Activity of Factor ⅩⅡ

目的 研究五种血液净化膜材即磺化聚醚砜(PES- SO3Na)、聚醚砜(PES)、聚砜(PS)、聚甲基丙烯酸甲酯(PMMA)、醋酸纤维素(CA)活化凝血十二因子(F )的时间动力学,以及三种抗凝剂(肝素、枸橼酸钠、乙二胺四乙酸二钠)对 因子接触活化的影响。方法 采用测定材料结合的F 的活化产物α- F a的促凝活性水平用来评价接触活化的程度。结果 1材料不同活化F 的速度和程度不同;同一材料与不同抗凝剂抗凝血浆孵育,活化F 的程度不同;2不论使用哪种抗凝剂,PES- SO3Na活化F 的程度都是最低的。结论 1五种膜材中,PES-SO3Na表面吸附的血浆F 的活化程度最小,血液相容性最好;2材料表面的F 的接触活化受到抗凝剂的影响。

Objective This study was conducted to examine the degree of contact activation of five blood purification materials sulfonated polyethersulfone (PES-SO_3Na), polyethersulfone (PES), polysulfone (PS), polymethylmethacrylate (PMMA) and cellulose acetate (CA) after they were incubated in anticoagulant-containing human plasma for 10 minutes at 37 ℃. Methods Three anticoagulants Heparin, Trisodium citrate and Disodium EDTA were used. The time course for generation of FⅩⅡ activity by the materials after incubation in anticoagulant-containing human plasma was evaluated. The degree of contact activation was determined by measuring membrane-bound α- FⅩⅡa activity level. Results ①The five materials caused different increase at different rate in the generation of α- FⅩⅡa after they were separately incubated with each of the three anticoagulants. ②PES-SO_3Na activated the least FⅩⅡ no matter which anticoagulant the plasma contained. Conclusion Contact activation can be mediated by antithrombotic agent. PES-SO_3Na has the best blood compatibility with respect to contact activation considering intrinsic coagulation.