Compare The Adsorption Effect Of Bilirubin,Bile Acid And Blood Ammonia By Plasma Perfusion With Several Sorbents

Objective:Compared the clearance effect of plasma perfusion on Hepatic failure patient by several sorbents,to make some helps for the development of a new clinical effective hemoperfusion sorbent to treat the hepatic failure.Methods:Collect four hepatic failure patients' plasma sample,and assigned each plasma into 11 groups according to different sorbents:Groupâ… :synthesis macroporous adsorptive resin of single use hemoperfutor from LIVZON corporation;groupâ…¡:activated charcoal coating with albumin; groupâ…¢:AB-8 macroporous adsorptive resin;groupâ…£:AB-8 macroporous adsorptive resin with diamine arms and coating with albumin;groupâ…¤:AB-12 macroporous adsorptive resin;groupâ…¥:AB-12 macroporous adsorptive resin with diamine arms and coating with albumin;groupâ…¦:ethyl cellulose coating with albumin;groupâ…§:ethyl cellulose with glutaraldehyde arms and coating with albuminGroupâ…¨:ethyl cellulose with PME ligands and coating with albumin;groupâ…©:ethyl cellulose with AMIKACINI ligands and coating with albumin;groupâ…ª:blank.The hepatic failure patients' plasma was treated by the 11 hemoperfutor individually.And plasma total bilirubin(TBIL),bile acid(TBA),blood ammonia(NH₃)were detected before perfusion(CO),and after the first(C1), second(C2),third(C3)cycle.Result:1.The clearance effect on total bilirubin:Following the process of plasma perfusion,the concentration of TBIL of groupâ… ,â…¡,â…¢,â…£,â…§,â…¨,â…©was lower and lower.There was significant difference between C3 and C0 of each group,(p＜0.05).But in groupâ…¤,â…¥,â…ªandâ…¦,the concentration after plasma perfusion was almost the same as the initial concentration,no significant difference between C3 and C0 of each group(p＞0.05).And the result of contrasting clearance effect on TBIL of sorbents was: groupⅧ＞groupⅠ＞groupⅡ＞groupⅩ＞groupⅨ＞groupⅣ＞groupⅢ＞groupⅥ＞groupⅦ＞groupⅤ＞groupâ…ª.There was no significant difference between groupâ…¡and groupâ…©(p＞0.05),also no significant difference among groupâ…¢,groupâ…£and groupâ…¨(p＞0.05),and no significant difference among groupâ…¥,groupâ…¦,groupâ…¤and groupâ…ª.But significant difference was existed between each two others(p＜0.05).The groupâ…§had the best clearance effect on TBIL.On the contrary,the groupâ…¥,groupâ…¦,groupâ…¤and groupâ…ªhad the worst clearance effect. 2.The clearance effect on TBA:Following the process of plasma perfusion,the concentration of TBA of groupâ… ,â…¡,â…¢,â…£,â…¤,â…¥,â…§,â…¨,â…©was lower and lower.There was significant difference between C3 and C0 of each group, (p＜0.05).But in groupâ…ªandâ…¦,the concentration after plasma perfusion was almost the same as the initial concentration,no significant difference between C3 and C0 of each group(p＞0.05).And the result of contrasting clearance effect on TBA of sorbents was: groupⅡ＞groupⅣ＞groupⅨ＞groupⅧ＞groupⅠ＞groupⅩ＞groupⅥ＞groupⅢ＞groupⅤ＞groupⅪ＞groupâ…¦.There was no significant difference between groupâ…£,groupâ…¨and groupâ…§,(p＞0.05),no significant difference among groupâ… ,groupâ…©,groupâ…¥,(p＞0.05),also no significant difference among groupâ…¢and groupâ…¤,and no significant difference among groupâ…ªand groupâ…¦.But significant difference was existed between each two others(p＜0.05).The groupâ…¡had the best clearance effect on TBA.On the contrary,the groupâ…¢,groupâ…¦,groupâ…¤and groupâ…ªhad the worst clearance effect. 3.The clearance effect on blood ammonia:Following the process of plasma perfusion,the concentration of NH₃ of all groups was lower and lower,There was significant difference between C3 and C0 of each group,(p＜0.05).And the result of contrasting clearance effect on NH₃ of sorbents was groupⅧ＞groupⅠ＞groupⅡ＞groupⅦ＞groupⅨ＞groupⅣ＞groupⅩ＞groupⅢ＞groupⅪ＞groupⅥ＞groupâ…¤.There was no significant difference between groupâ…£,groupâ…¦,groupâ…©and groupâ…¨(p＞0.05), and also no significant difference among groupâ…¤,groupâ…¥and groupâ…ª. But significant difference was existed between each two others(p＜0.05).The groupâ…§had the best clearance effect on NH₃.On the contrary,the groupâ…¥,groupâ…¤and groupâ…ªhad the worst clearance effect. Conclusion:1.Clearance effect on bilirubin of sorbents was:ethyl cellulose with glutaraldehyde arms and coating with albumin＞synthesis macroporous adsorptive resin of single use hemoperfutor from LIVZON corporation.＞activated charcoal coating with albumin,ethyl cellulose with AMIKACINI ligands and coating with albumin＞ethyl cellulose with PME ligands and coating with albumin,AB-8 macroporous adsorptive resin,AB-8 macroporous adsorptive resin with diamine arms and coating with albumin.And AB-12 macroporous adsorptive resin,AB-12 macroporous adsorptive resin with diamine arms and coating with albumin and ethyl cellulose coating with albumin can not remove bilirubin.2.Clearance effect on bile acid of sorbents was:activated charcoal coating with albumin＞AB-8 macroporous adsorptive resin with diamine arms and coating with albumin,ethyl cellulose with glutaraldehyde arms and coating with albumin,ethyl cellulose with PME ligands and coating with albumin＞synthesis macroporous adsorptive resin of single use hemopeffutor from LIVZON corporation,AB-12 macroporous adsorptive resin with diamine arms and coating with albumin,ethyl cellulose with AMIKACINI ligands and coating with albumin＞AB-12 macroporous adsorptive resin,AB-8 macroporous adsorptive resin.And ethyl cellulose coating with albumin can not remove bile acid. 3.Clearance effect on bl0od ammonia of sorbents was:ethyl cellulose with glutaraldehyde arms and coating with albumin＞synthesis macroporous adsorptive resin of single use hemoperfutor from LIVZON corporation＞activated charcoal coating with albumin＞AB-8 macropomus adsorptive resin with diamine arms and coating with albumin,ethyl cellulose coating with albumin,ethyl cellulose with PME ligands and coating with albumin,ethyl cellulose with AMIKACINI ligands and coating with albumin＞AB-8 macroporous adsorptive resin.And AB-12 macropomus adsorptive resin with diamine arms and coating with albumin,AB-12 macroporous adsorptive resin can not remove blood ammonia.In summary,ethyl cellulose with glutaraldehyde arms and coating with albumin,synthesis macroporous adsorptive resin of single use hemoperfutor from LIVZON corporation and activated charcoal coating with albumin,are the most effective sorbents for bilirubin,bile acid and blood ammonia.And the ethyl cellulose with glutaraldehyde arms and coating with albumin have large application potential.