【作者】 白淑艳；

【导师】 高志红；

【作者基本信息】 大连医科大学 ， 内科学， 2006， 硕士

【摘要】 背景:目前腹水浓缩(或超滤)回输被认为是肝硬化失代偿期顽固性腹水的有效治疗方法之一。腹水的直接回输、浓缩回输或采用特定孔径的半透膜所进行的超滤回输,迅速消除了腹水的同时又回输了腹水中的蛋白质,但是腹水中的内毒素、胆红素等有毒物质也被回输到患者体内。二醋酸纤维素(CA)/聚乙烯基亚胺(PEI)共混制备微孔滤膜(以下简称CA/PEI亲和膜)能有效去除多种溶液中的内毒素,对胆红素也有吸附作用。CA/PEI亲和膜能否有效去除腹水中的内毒素,满足腹水回输治疗的需要,是本课题研究的出发点。目的:本实验对CA/PEI亲和膜去除肝硬化腹水中的内毒素进行了研究。考察了流速、溶液中蛋白质浓度、温度等因素对去除腹水中内毒素效果的影响,并对其结果作了分析,期望为肝硬化顽固性腹水的回输治疗提供一个安全有效的措施。方法:采用静态吸附和动态吸附两种方法,在不同条件(流速、溶液中蛋白质浓度、温度等)下对腹水中内毒素去除效果进行了研究,同时也考察了CA/PEI亲和膜对腹水中胆红素的吸附情况。应用BET-16细菌内毒素测定仪,采用动态浊度法,选择灵敏度为0.06EU/ml的鲎试剂,测定内毒素浓度,同时在我院化验室应用双缩脲法测定腹水中蛋白浓度及钒酸盐法测定腹水中胆红素浓度,根据吸附前后的浓度差,计算内毒素及胆红素去除率,蛋白回收率。结果:1.亲和膜对无人血白蛋白(HSA)水溶液中内毒素的去除率,静态法89.1%,动态法98.5%;加入HSA水溶液中内毒素的去除率,静态法82.0%,动态法87.8%。可见蛋白质影响了去离子水溶液中内毒素的去除。蛋白回收率,静态法98.0%,动态法96.1%,说明亲和膜对HSA吸附性很小。温度在4℃、25℃、37℃条件下去离子水溶液中内毒素更多还原

【Abstract】 Background:At present, there is still no operative method for the treatment of refractory ascites of liver cirrhosis. Direct or concentrated reinfusion of self-ascites as well as ultrafiltration ascites reinfusion by definite objective bapertur dialyzer can not only preclud the ascites quickly but also get the albumin in the ascites back into the body. However the noxious substance such as endotoxin and bilirubin will convey back the circulation at the same time. The microfiltration membrane adsorber which can selectively remove endotoxin by employing polyethyleneimine (PEI)as affinity ligand, was prepared by blending cellulose diacetate(CA) and PEI. CA/PEI affinity memberane has achieved efficient adsorptioin of endotoxin and bilirubin from some goal solutes. We hope this membrane can meet the demands in the application of ascites reinfusion treatment .Objective:This study mainly deal with the removal of endotoxin in the ascites of liver cirrhosis by CA/PEI memberane. In order to get the appropriate condition for the adsorption of endotoxin, the ascites flow rate, the temperature and the concentration of protein were inspected and analyzed. We expected to provide a new material in the ascites reinfusion treatment which can effectively get rid of endotoxin before the ascites being concentrated or ultrafiltrated and then going back into the patients.Methods: Through static and dynamic adsorption using CA/PEI memberane, we investigated and compared the effects on deionized water and the ascites endotoxin removal in different conditions(flow rate, protein concentration and temperature). we also simultaneously paid attention to the removal of bilirubin in the ascites. Kinetic-Turbidimetric methods was更多还原