CA/PEI及CA/HPC亲和膜去除肝硬化腹水中内毒素对比研究

Study on endotoxin removal in ascites of cirrhosis by CA/PEI and CA/HPC affinity membranes

目的观察醋酸纤维素/聚乙烯基亚胺(CA/PEI)及醋酸纤维素/疏水阳离子(CA/HPC)亲和膜对肝硬化腹水中内毒素的去除效果。方法以CA为亲和基质,分别交连PEI及HPC,制备CA/PEI及CA/HPC亲和膜;采用动态吸附法,比较吸附前后肝硬化腹水中内毒素、白蛋白、免疫球蛋白(IgG、IgA、IgM)、离子(K+、Na+、Cl-)及胆红素浓度的变化。结果两种亲和膜吸附前后腹水中的内毒素浓度显著降低(P<0.01);腹水中的白蛋白、免疫球蛋白、电解质浓度过膜前后无明显变化;CA/PEI亲和膜能显著降低腹水中的胆红素的浓度。结论两种亲和膜均能有效吸附肝硬化腹水中的内毒素,对腹水中的白蛋白、免疫球蛋白、电解质无明显截留,CA/PEI亲和膜可同时有效吸附腹水中的胆红素,两种亲和膜均可应用于肝硬化自体腹水回输治疗。

Objective To investigate the removal effect of endotoxin from ascites of cirrhosis by CA/PEI and CA/ HPC affinity membranes. Methods The CA/PEI and CA/HPC affinity membranes were prepared by employing cellulos diacetate （CA） as matrix immobilized polyethyleneimine （PEI） and cationic charged groups （HPC） respectively as affinity ligand. Through dynamic absorption using these two affinity membranes, we compared the concentration changes of eodotoxin, albumin, immunoglobulin （ IgG, IgA, IgM） , electrolyte （ K ^＋ , Na ^＋ , Cl^- ） and bilirubin in the ascites of cirrhosis before and after it passed through each of the membranes. Results The endotoxin level was greatly reduced （P 〈 0.01 ） after the ascites absorbed by each of the affinity membranes. There were no marked changes for the concentration of albumine, immunoglobulin and electrolyte in the ascites of cirrhosis. CA/PEI affinity membranes could greatly decrease the bilirubin concentration in the ascites of cirrhosis. Conclusion CA/PEI and CA/HPC affinity membranes can effectivly absorb the endotoxin from the ascites of cirrhosis, but have no obviously influence on the albumine, immunoglobulin and electrolyte at the same time; CA/PEI affinity membrane can simultaneously absorb the bilirubin from the acities of cirrhosis. These results suggest that CA/PEI and CA/HPC affinity membranes can be applied to the treatment of self-ascites reinfusion.