用HB—H-7树脂吸附血浆内毒素和炎症细胞因子的体外实验研究

Study on the adsorption of endotoxin and proinflammatory eytokines with HB-H-7 resin in vitro

目的通过体外实验探讨使用HB—H-7树脂吸附血浆内毒素及炎症细胞因子的有效性和安全性。方法静态吸附实验：树脂与内毒素阳性患者血浆按1；10比例混合，置37℃恒温水浴振荡2h。动态吸附实验：将内毒素阳性患者血浆经过装有树脂的自制灌流器中灌流2h。测定灌流前后血浆内毒素、炎症细胞因子、蛋白质和电解质浓度，计算吸附率。比较静态与动态不同吸附方式以及不同温度血浆灌流前后（30、60、120min）血浆内毒素浓度的变化，并计算吸附率。结果静态吸附实验中，用HB—H-7树脂吸附后，血浆内毒素和炎症细胞因子含量均显著降低（P均〈0．05），内毒素、肿瘤坏死因子-α、白细胞介素-1、6、8的吸附率分别为99．2％、55．0％、57．0％、75．0％、42．0％；而对蛋白质影响较小（P均〈0．05）；对电解质无明显影响（P均〉0．05）。动态与静态血浆内毒素吸附率比较差异无统计学意义（99．8％比99．1％，P〉0．05），37℃与25℃下血浆内毒素吸附率比较差异亦无统计学意义（99．8％比99．9％，P〉0．05）。结论HB—H-7树脂对内毒素及炎症细胞因子有明显吸附效果，对蛋白质影响较小，对电解质无明显影响。

Objective To study the effieaey and safety of adsorption of endotoxin and proinflammatory eytokines with HB-H-7 resin in vitro. Methods Static adsorption experiment： HB-H-7 resin was added into plasma of endotoxin-positive patients aeeording to the ratio of 1 ： 10. Then, they were put in a constant temperature water bath oseillator, and oscillated for 2 hours. Before and after the experiment, plasma endotoxin, proinflammatory eytokines, protein and electrolytes were detected, and the rate of 2-hour absorption was calculated. The experiment was repeated 10 times. Dynamic adsorption experiment： 5 ml resin was put into a self-made perfusion unit. Endotoxin-positive patients plasma （50 ml） was perfused for 2 hours. The flow rate of plasma was eontrolled at 4 ml/min with the infusion pump, and the plasma endotoxin was determined at 0, 30, 60 and 120 minutes after plasma hemoperfusion, and the absorption rates were calculated. The results were compared with static adsorption. The influence of temperature during adsorption was determined as follows. Perfusion method was similar with dynamie adsorption experiment. The perfusion units were either plaeed in a 37 ℃ water path or 25℃ （room temperature）. Then, the plasma endotoxin was measured 2 hours after plasmaperfusion, and the absorption rates were calculated. Results In static adsorption experiment, the plasma endotoxin and proinflammatory eytokines were significantly lower after adsorption with HB-H-7 resin adsorption （all P〈0. 05）. The adsorption rates of endotoxin, tumor neerosis faetor-α and interleukin-1, 6, 8 were 99.2%, 55.0%, 57.0%, 75.0%, 42.0%, respeetively. Changes in protein were small （all P〈0. 05）, and there was no signifieant ehange in plasma eleetrolytes （all P〉0. 05）. Dynamic adsorption rate was higher than that of statie, but the differenees were not signifieant （99.8% vs. 99.1%, P〉0.05）. There was no statistieally signifieant differenee between differenee in temperature （37 ℃ vs. 25 ℃, 99.8% vs. 99.9%, P〉0.05）. Conclusion HB-H-7 resin effectively adsorbes endotoxin and proinflammatory eytokines in vitro. Its adsorption rate for protien is lower, and it has no obvious effeets on electrolytes.