摘要
传统的非生物人工肝大多是血液净化方法在肝衰竭治疗中的应用,包括血浆置换、血液灌流、血液滤过、血液透析、连续性血液透析滤过等。目前多种血液净化方法联合治疗是非生物型人工肝治疗的热点和研究方向,因此非生物人工肝支持系统多采用目前现有的多功能血液净化设备,进行多种血液净化方式联合治疗。随着血液净化技术的不断发展,非生物人工肝也出现了一些新的解毒方法和装置,如:普罗米修斯人工肝、白蛋白分子吸附再循环系统等,该类非生物人工肝一般具有两个循环,将传统血液透析与白蛋白吸附结合,分别清除白蛋白结合物毒素和水溶性毒素。因此,该类设备需要在传统血液透析机的基础上增加白蛋白吸附模块,提供动力以及吸附器清除白蛋白结合物毒素,并对该循环提供安全性能监控。生物人工肝由3部分组成:生物成分、生物反应器、体外循环装置。其中生物反应器是生物人工肝的核心部分,其性能直接关系到人工肝的效率和效果。因此,与非生物人工肝相比,生物人工肝支持系统需要增加针对生物反应器的支持与辅助装置,包括生物反应器循环的动力提供,生物反应器的营养支持,氧气补充、温度恒定以及代谢物处理,除此之外还应该监测生物反应器中生物成分的活性,保证生物反应器的性能。
Traditional non-biological artificial liver is mostly applied by blood purification therapy in the treatment of patients with liver failure,including plasma exchange,hemoperfusion,hemofiltration,hemodialysis,continuous hemodiafiltration and so on.Currently,most researches mainly concentrate in the combination therapy with blood purification methods,so the support system can choose the multi-function blood purification device.With the continuous development of blood purification techniques,there are some new non-biological artificial liver systems,such as the molecular adsorbents recirculating system（MARS） and the Prometheus system.This kind of non-biological artificial liver system combine detoxification of water-soluble and protein-bound toxins in a dialysis system.Therefore,the support device should increase albumin adsorption module to provide power and remove albumin adsorbed conjugates toxins,ensuring the security for the performance monitoring.Bioartificial liver system is composed of three parts： biological components,bioreactor,and in vitro cycle device.Bioreactor is the core part of the bioartificial liver system,whose performance is directly related to the efficiency and effectiveness of artificial liver.Compared with non-biological artificial liver support system,the bioartificial liver support system should increase some parts to support the bioreactor.The increased parts include the power of bioreactor cycle,oxygenating part,temperature control part,and metabolites processing part.The bioartificial liver support system should also monitor the activity of biological components to ensure the performance of the bioartificial liver system.
出处
《透析与人工器官》
2010年第4期29-38,共10页
Chinese Journal of Dialysis and Artificial Organs
关键词
非生物人工肝支持系统
生物人工肝支持系统
生物反应器
non-biological artificial liver support system
bioartificial liver support system
bioreactor
