Tagaya Masashi, Hara Kazunobu, Takahashi Shunsuke, Nagoshi Saki, Handa Hiroki, Okano Shinya, Murataka Takuo
1 Department of Medical Engineering, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan.
2 Department of Nephrology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan.
Int J Artif Organs. 2019 Feb;42(2):88-94. doi: 10.1177/0391398818815480. Epub 2018 Nov 29.
: Extracorporeal circulation devices are coated with a biocompatible polymer coating agent (BPCA) that has a hydrophilic blood-contacting layer, but hemofilters are not. We aimed to investigate the antithrombotic properties of a BPCA-coated hemofilter.
: Four experiments using BPCA-coated circuits and non-coated hemofilters and four experiments using BPCA-coated circuits and BPCA-coated hemofilters were performed with whole human blood and compared by measuring the circuit pressure every 5 min, antithrombin activity every 40 min, and thrombin-antithrombin complex every 40 min, for a total of 240 min of recirculation.
: The mean time required for the pressure at the inlet of the hemofilter to increase sharply was longer in BPCA-coated than in non-coated hemofilters (66 ± 11 min vs 25 ± 9 min, p < 0.01). The mean antithrombin activity value at 200 and 240 min of recirculation was significantly higher in the experiments with BPCA-coated versus non-coated hemofilters (43.3 ± 2.87 vs 33.3 ± 5.74, p = 0.04; 42.8 ± 3.59 vs 31.0 ± 5.35, p = 0.01, respectively); the antithrombin activity values at the other time points were not significantly different. Furthermore, all thrombin-antithrombin complex values in experiments with the BPCA-coated hemofilters achieved overrange at 80 min of recirculation, whereas those with the non-coated hemofilter achieved overrange at 40 min.
: This study suggests that BPCA-coated hemofilters can inhibit antithrombin consumption, contributing to antithrombotic effects in extracorporeal circulation circuits.
体外循环装置涂有具有亲水性血液接触层的生物相容性聚合物涂层剂（BPCA），但血液滤过器没有。我们旨在研究BPCA涂层血液滤过器的抗血栓特性。
使用BPCA涂层回路和未涂层血液滤过器进行了四项实验，以及使用BPCA涂层回路和BPCA涂层血液滤过器进行了四项实验，均使用全血进行，并通过每5分钟测量回路压力、每40分钟测量抗凝血酶活性以及每40分钟测量凝血酶 - 抗凝血酶复合物，进行了总共240分钟的再循环，并对结果进行比较。
BPCA涂层血液滤过器入口压力急剧升高所需的平均时间比未涂层血液滤过器更长（66±11分钟对25±9分钟，p<0.01）。在再循环200分钟和240分钟时，BPCA涂层血液滤过器组的平均抗凝血酶活性值显著高于未涂层血液滤过器组（分别为43.3±2.87对33.3±5.74，p = 0.04；42.8±3.59对31.0±5.35，p = 0.01）；其他时间点的抗凝血酶活性值无显著差异。此外，BPCA涂层血液滤过器组实验中所有凝血酶 - 抗凝血酶复合物值在再循环80分钟时超过范围，而未涂层血液滤过器组在40分钟时超过范围。
本研究表明，BPCA涂层血液滤过器可抑制抗凝血酶消耗，有助于体外循环回路中的抗血栓作用。
