Monhart V, Balíková M, Tlust'áková M
3. vnitrní oddĕlení Ustrední vojenské nemocnice, Praha.
Cas Lek Cesk. 1994 Mar 21;133(6):181-3.
Haemoperfusion was introduced in the treatment of intoxications with Amanita phalloides in 1974. Haemoperfusion over active charcoal is used most frequently. The objective of the present study was to compare the sorption capacity of Czech haemoperfusion sorbents of the charcoal and resin type for amatoxins extracted from dried Amanita phalloides.
Haemoperfusion sorbents on the basis of charcoal-Chemviron SC XII and on the basis of synthetic resin--Amberlite XAD 2 were used in experiments in vitro. Recirculation of an aqueous extract of Amanita phalloides over a haemoperfusion column with a volume of 400 ml located in a closed system took 4 hours. Amanitin levels (alpha and beta) were assessed by HPLC. Two-hour perfusion over Amberlite XAD led to removal of the entire amount of both amanitins from the aqueous solution. Four-hour perfusion over charcoal, however, reduced the original alpha amanitin level by 24% (p < 0.05) and of beta amanitin by 8% (change not significant). Extraction of alpha and beta amanitin by the resin sorbent varied between 0.95-1.00. The type of charcoal used, produced from the shells of coconuts, had a low extraction activity, cca 12%.
The assembled results provide evidence that the synthetic resin Amberlite XAD 2 has a more than ten times greater sorption capacity, as compared with charcoal (Chemviron SC XII) and that in experiments in vitro it removes rapidly and effectively alpha and beta amanitin from an aqueous solution. Although during sorption of mycotoxins from plasma or blood the sorption rate and total capacity declines amberlite resins (Czech haemoperfusion column Hemabsorb A2) can be recommended for use in clinical toxicology.
血液灌流于1974年被引入用于治疗毒鹅膏中毒。最常使用的是活性炭血液灌流。本研究的目的是比较捷克产的活性炭型和树脂型血液灌流吸附剂对从干毒鹅膏中提取的鹅膏毒素的吸附能力。
实验体外使用了基于活性炭（Chemviron SC XII）和基于合成树脂（Amberlite XAD 2）的血液灌流吸附剂。毒鹅膏水提取物在封闭系统中通过体积为400 ml的血液灌流柱再循环4小时。通过高效液相色谱法评估鹅膏毒肽水平（α和β）。在Amberlite XAD上进行两小时灌流可使两种鹅膏毒肽从水溶液中全部去除。然而，在活性炭上进行四小时灌流，可使初始α鹅膏毒肽水平降低24%（p < 0.05），β鹅膏毒肽水平降低8%（变化不显著）。树脂吸附剂对α和β鹅膏毒肽的提取率在0.95 - 1.00之间。所用的由椰子壳制成的活性炭类型具有较低的提取活性，约为12%。
综合结果表明，合成树脂Amberlite XAD 2的吸附能力比活性炭（Chemviron SC XII）大十多倍，并且在体外实验中能快速有效地从水溶液中去除α和β鹅膏毒肽。尽管在从血浆或血液中吸附霉菌毒素时，吸附速率和总容量会下降，但琥珀lite树脂（捷克血液灌流柱Hemabsorb A2）可推荐用于临床毒理学。
