新型胺基壳聚糖血浆灌流治疗犬肝功能衰竭的疗效及安全性

An experimental study of plasma-perfusion with a novel aminated chitosan on liver failure in a canine model

目的观察新型胺基壳聚糖血浆灌流治疗肝功能衰竭犬的有效性及安全性。方法应用新型胺基壳聚糖树脂制备吸附罐。制作肝功能衰竭犬模型。采用新型胺基壳聚糖树脂对肝功能衰竭犬模型进行血浆灌流治疗，监测灌流过程中血压、体温变化。检测灌流前后及治疗15、30、60、120min时吸附罐入口、出口处血浆总胆红素、直接胆红素和间接胆红素水平；检测灌流前后全血ALT、AST、血氨、凝血酶原时间、电解质和血常规。结果血浆灌流结束时，总胆红素由（177．4±18．1）μmol／L降至（46．1±3．7）μmol／L，直接胆红素由（124．2±10．3）μmol／L降至（30．5±1．7）μmol／L，间接胆红素由（53．2±2．8）μmol／L降至（15．6±2．0）μmol／L，差异均有统计学意义（P〈0．05）。总胆红素、直接胆红素和间接胆红素在灌流15、30min时，出口处明显低于入口处（P〈0．05）；在60、120min时，出、入口处差别无统计学意义（P〉0．05）。血浆灌流后，血ALT、AST和血氨明显降低（P值均〈0．05），凝血酶原时间明显上升（P〈0．05），血常规、电解质无明显变化（P〉0．05）。灌流过程中血压、体温无明显变化。结论新型胺基壳聚糖树脂血浆灌流治疗犬肝衰竭安全、有效。

Objective To study the efficacy and safety of plasma-perfusion with a novel aminated chitosan on liver failure in a canine model. Methods A canine model of liver failure was established. Plasmaperfusion.with a novel aminated chitoson was performed on those dogs. Blood pressure and body temperature during plasma-perfusion were monitored. Total plasma bilirubin, direct bilirubin and indirect bilirubin at the entrance and exit of a column before and after plasma-perfusion and at the time of 15, 30, 60, and 120 min during plasma-perfusion were examined. Blood alanine aminotransferase, aspartate aminotransferase, amonia, plasma prothrombin time, electrolytes and other blood parameters were examined before and after the plasmaperfusion. Results After the plasma-perfusion, total bilirubin decreased from 177.4 ± 18.1 to 46.1 ± 3.7 （P 〈 0.05）, direct b＇tlirubin decreased from 124.2 ± 10.3 to 30.5 ± 1.7 （P 〈 0.05）, indirect bilirubin decreased from 53.2 ± 2.8 to 15.6 ± 2.0 （P 〈 0.05）. Compared at the entrance of the column, there were significant decreases in the levels of total bilirubin, direct bilirubin and indirect bilirubin of plasma at the exit of the column at the times of 15 and 30 min during plasma-perfusion （P 〈 0.05）; there were no further significant decreases at 60 and 120 min （P 〉 0.05）. Compared with pre-plasma-perfusion, there were significant decreases in the levels of blood alanine aminotransferase, aspartate aminotransferase, and amonia （P 〈 0.05）; the plasma prothrombin time was significantly increased （P 〈 0.05）, the electrolytes, hematocrit level, platelet count, and white cell count were not affected significantly by the perfusion （P 〉 0.05）; blood pressure and body temperature were not affected significantly during the plasma-perfusion. Conclusion Plasma-perfusion with a novel aminated chitosan resin is an effective and safe method for treating liver failure in this canine model.