Carruth W A, Byron M P, Solomon D D, White W L, Stoddard G J, Marosok R D, Sherertz R J
Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1042.
J Biomed Mater Res. 1994 Feb;28(2):259-67. doi: 10.1002/jbm.820280217.
In the development of a polyurethane vascular catheter with anti-infective properties, it became desirable to develop a measure of tissue inflammation. This was investigated in a rabbit model by implanting uncoated catheters and catheters coated with heparin (HEP), chlorhexidine (CH), or CH/HEP in the subcutaneous space with or without 10(4) Staphylococcus aureus. At intervals of 2, 4, and 7 days after implantation, animals were sacrificed; tissue blocks containing catheters were removed and preserved with formaldehyde; and sections were stained with hematoxylin and eosin. Using a histologic index, 240 sections (10 for each experimental condition) were evaluated by two investigators blinded to experimental conditions. Uncoated catheters or catheters coated with CH alone had a lower histologic index (less inflammation) than catheters coated with HEP alone or CH/HEP (P < .05). When catheters were inoculated with S. aureus, those coated with CH, with or without HEP, had a lower histologic index than uncoated catheters (P < .05). Next, 30 volunteers had a control catheter inserted in a vein in one forearm and a catheter coated with either CH alone or CH/HEP in a vein in the other forearm. After 96 h of observation there was a greater risk of phlebitis associated with CH/HEP catheters than control catheters (P < .05), and no difference in the risk of phlebitis between CH catheters and control catheters (P = 0.43). Thus, the amount of inflammation around the catheter in the subcutaneous space of rabbit correlated with the risk of peripheral vein phlebitis.
在开发具有抗感染特性的聚氨酯血管导管时，人们希望建立一种衡量组织炎症的方法。在兔模型中对此进行了研究，通过在皮下空间植入未涂层导管以及涂有肝素（HEP）、洗必泰（CH）或CH/HEP的导管，植入时有无接种10⁴金黄色葡萄球菌。植入后2天、4天和7天，处死动物；取出含有导管的组织块并用甲醛保存；切片用苏木精和伊红染色。使用组织学指数，由两名对实验条件不知情的研究人员对240个切片（每种实验条件10个）进行评估。未涂层导管或仅涂有CH的导管的组织学指数（炎症较少）低于仅涂有HEP或CH/HEP的导管（P<0.05）。当导管接种金黄色葡萄球菌时，涂有CH（无论有无HEP）的导管的组织学指数低于未涂层导管（P<0.05）。接下来，30名志愿者在一侧前臂的静脉中插入对照导管，在另一侧前臂的静脉中插入仅涂有CH或CH/HEP的导管。观察96小时后，与对照导管相比，CH/HEP导管发生静脉炎的风险更高（P<0.05），CH导管与对照导管之间静脉炎风险无差异（P = 0.43）。因此，兔皮下空间导管周围的炎症程度与外周静脉静脉炎的风险相关。
