摘要
体外生命支持(ECLS)技术是救治心源性休克、急性呼吸窘迫综合征(ARDS)等危重症的重要技术手段,但其临床应用仍受限于材料-血液界面的生物相容性问题。本文综述了ECLS涂层技术的最新研究进展,系统分析了不同涂层的分子机制及临床应用挑战。重点阐述了目前几种主流的涂层技术的优缺点,包括肝素涂层、磷酸胆碱涂层、一氧化氮涂层等。另外,本文还总结了目前几种新型涂层技术的应用和发展现状,如表面内皮化涂层、新型离子聚合物涂层等。目前仅肝素和磷酸胆碱涂层具备成熟的临床适用性,其他涂层技术在发挥优势的同时仍存在某些不足,因此大部分新型涂层材料需要进一步的基础和临床验证来不断改良。未来研究应致力于开发多功能复合涂层,整合纳米技术和仿生设计,以优化ECLS系统的长期血液相容性以及改善炎症反应。
Extracorporeal life support(ECLS)is a critical therapeutic modality for managing patients with life-threatening conditions such as cardiogenic shock and acute respiratory distress syndrome(ARDS).However,its clinical application remains constrained by biocompatibility challenges at the blood-material interface.This review comprehensively examines recent advances in ECLS coating technologies,and systematically analyzies their molecular mechanisms and clinical implementation challenges.We critically evaluate the advantages and limitations of mainstream coating strategies,including heparinized coatings,phosphorylcholine-based polymers,and nitric oxide-releasing surfaces.Furthermore,we discuss emerging coating technologies,such as endothelial-mimicking coatings and novel ionic polymer composites.To date,only heparin and phosphorylcholine coatings have achieved widespread clinical adoption,while other coatings exhibit distinct limitations despite their potential benefits.Thus,most novel coating materials require further optimization through preclinical and clinical validation.Future research should prioritize the development of multifunctional composite coatings that integrate nanotechnology and biomimetic designs to enhance long-term hemocompatibility and mitigate inflammatory responses in ECLS systems.
作者
高天宇
刘钦东
刘佳
王赫
靳雨
刘晋萍
GAO Tianyu;LIU Qindong;LIU Jia;WANG He;JIN Yu;LIU Jinping(Extracorporeal Circulation Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)
出处
《中国体外生命支持》
2025年第6期543-548,共6页
CHINESE JOURNAL OF EXTRACORPOREAL LIFE SUPPORT
基金
中国医学科学院医学与健康科技创新工程项目(2024-12M-C&T-B-045)。
关键词
涂层技术
体外生命支持
体外膜氧合
体外循环
抗凝
肝素
磷酸胆碱
危重症
coating technology
extracorporeal life support
extracorporeal membrane oxygenation
extracorporeal circulation
anticoagulation,heparin
phosphorylcholine
critical illness
