Institute of Blood Transfusion, Chinese Academy of Medical Sciences and Peking Union Medical College, Chengdu, China.
J Mater Sci Mater Med. 2013 Aug;24(8):1985-92. doi: 10.1007/s10856-013-4950-1. Epub 2013 May 18.
This paper reports the results of an in vitro investigation into the blood response of medical grade poly (vinyl chloride) (PVC), and two types of plasticized PVC in tubing or sheet form, with di-(2-ethylhexyl)phthalate (DEHP) and di(isononyl) cyclohexane-1,2-dicarboxylate (HEXAMOLL(®) DINCH) as plasticizer, were selected for assessment of complement activation, coagulation system and platelet activation. The results of the study show that not only the plasticizers at PVC surface have an influence on complement activation, but also the incubation condition such as incubation time and the diameter of PVC tubing. Under static status, C3a, C5a and SC5b-9 concentration in the blood were higher after contacting with PVC plasticized with DEHP (PVC1) than after contacting with PVC plasticized with DINCH (PVC2). However, under dynamic circulation, the results were totally converse, which may be due to smaller diameter and higher shear rate of PVC2. In addition, there was a significant increase of activated partial thrombin time (APTT) and decrease of FIX concentration after plasma contacting with the PVC tubing, which indicated that the intrinsic pathway may be impacted when blood contacted with PVC tubing. However, there was no significant difference of APTT, FIX concentration and CD62p expression rate between the two materials. Moreover, the migration in the DINCH system was considerably lower than for DEHP, which indicates that DINCH could be a promising alterative plasticizer of DEHP.
本文报告了一项关于医用级聚氯乙烯（PVC）和两种增塑型 PVC 管材和片材的血液反应的体外研究结果，这两种 PVC 管材和片材分别以邻苯二甲酸二（2-乙基己基）酯（DEHP）和二异壬基环己烷-1,2-二羧酸酯（HEXAMOLL(®) DINCH）为增塑剂。研究选择了这两种增塑剂来评估补体激活、凝血系统和血小板激活。研究结果表明，不仅 PVC 表面的增塑剂会影响补体激活，而且孵育条件（如孵育时间和 PVC 管的直径）也会有影响。在静态条件下，与用 DEHP 增塑的 PVC（PVC1）接触后，血液中的 C3a、C5a 和 SC5b-9 浓度高于与用 DINCH 增塑的 PVC（PVC2）接触后的浓度。然而，在动态循环条件下，结果完全相反，这可能是由于 PVC2 的直径较小且剪切率较高。此外，与 PVC 管接触后的血浆中活化部分凝血活酶时间（APTT）显著增加，FIX 浓度降低，这表明当血液与 PVC 管接触时，内源性途径可能受到影响。然而，两种材料之间的 APTT、FIX 浓度和 CD62p 表达率没有显著差异。此外，DINCH 体系中的迁移量明显低于 DEHP，这表明 DINCH 可能是 DEHP 的一种有前途的替代增塑剂。
