兼具血液相容性和毒物吸附的灌流活性炭研究

Due to the powerful ability to adsorb the organic solutes, activated carbon (AC) has been widely used as an adsorbent in haemofiltration therapy to remove the harmful solutes from patent blood and it has been shown to be an effective therapy for acute severe, multiple organ failure or sepsis patients to survive, to regenerate the patent plasma or to augment the treatment modalities of patent. The problem for AC used in haemofiltration therapy is that the adsorption of the toxins with middle size was prevented by the coated membrane, which was coated on AC to improve the blood compatibility of AC. Furthermore, the factor by which a better blood compatibility of AC was caused is still unclear. The objective of this research is to investigate the factors that influence or control the blood compatibility and adsorption capacity of AC for the increase of the blood compatibility and adsorption capacity on AC, and finally to obtain an AC possessing improved blood compatibility and enhanced adsorption capacity for toxins , specially for the toxins at middle size.

活性炭血液灌流是利用活性炭吸附病人血液中不同尺寸的毒物而达到治疗的方法，在治疗肝功能衰竭、败血症等疾病尤其在抢救急性中毒病人中有重要应用。目前存在的问题是：直接使用活性炭虽能很好吸附不同尺寸的毒物但血液相容性差，活性炭包膜后虽相容性好，但毒物吸附下降，导致治疗或抢救效果下降。申请人发现：活性炭经氧化改性后不但血液相容性好，毒物吸附也增加，显示出解决问题的重要潜力。基于此，项目拟对活性炭系统改性，研究其表面含氧基团和织构对血液相容性和毒物吸附的影响，找出改性后血液相容性和毒物吸附提高的主要因素，然后综合这些因素改性活性炭，获得血液相容性和毒物吸附都显著提高的活性炭，希望它在病人抢救和疾病治疗中获得更好疗效和更广泛的应用。

项目主要通过使用过氧化氢、硝酸等对煤质活性炭、椰壳活性炭和医用血液灌流球状活性炭等进行氧化改性，研究了改性对活性炭血液相容性和毒物吸附性的影响。其中，通过改性对蛋白质吸附、溶血性和凝血性等因素的影响，考察了改性对活性炭血液相容性的影响；通过考察改性对胆红素、尿酸、肌酐、苯巴比妥钠、百草枯等的吸附，考察了改性对血液中典型内源性毒物和外源性毒物的吸附影响。结果表明，由于改性在活性炭表面引入了含氧基团，使得活性炭对蛋白质吸附降低，进而使其溶血性与凝血性显著下降，其中，活性炭表面羧酸基团、酚羟基和内酯基等的引入都有利于溶血性的下降；活性炭表面羧酸基团的脱去和酚羟基和内酯基的引入对于凝血性的降低有利；由于表面含氧基团的引入和介孔的提高，氧化改性可以显著提高了活性炭对血液内源性物质胆红素、肌酐的吸附脱除，同时也有利于活性炭对外源性毒物如苯巴比妥钠、百草枯等的吸附脱除。此外，项目结果还表明，由于表面含氧基团的提高，改性可能会提高活性炭对血液中金属离子的吸附，提示使用改性活性炭进行血液灌流时，注意金属离子的流失。