PDF(Pubmed)
Abstract：
Vascular injury such as central venous stenosis (CVS) is a common complication in hemodialysis patients with central venous catheters (CVCs), yet the impact of the microstructure and partial physic characteristics of catheter surface on the chronic injury of central vein has not been elucidated. In this study, the microscopic morphology of tips and bodies of six different brands of polyurethane CVCs was observed and their roughness was assessed. Subsequently, an in vitro model was established to measure the coefficients of friction (COF) between CVCs (tips and bodies) and the vena cava intima of Japanese rabbits under the same condition in a linear reciprocating mode, and changes in the intima of vessels after friction were observed. The study found that there was a significant variation in surface roughness among different brands of CVCs (tips P < 0.001, bodies P = 0.02), and the COF was positively correlated with the catheter surface roughness (tips P = 0.005, R = 0.945, bodies P = 0.01, R = 0.909). Besides, the endovascular roughness increased after friction. These findings suggest that the high roughness surface of CVCs may cause chronic mechanical friction injury to the central venous intima, which is one of the potential factors leading to CVS or occlusion. This provides a breakthrough for reducing complications, improving patient prognosis, and advancing catheter surface lubrication technology.
摘要：
中心静脉导管(CVC)等血管损伤是血液透析患者常见的并发症,然而，导管表面的微观结构和部分物理特征对中央静脉慢性损伤的影响尚未阐明。在这项研究中,观察了六种不同品牌聚氨酯CVC的尖端和主体的微观形态，并评估了它们的粗糙度。随后，建立了一个体外模型，以线性往复模式在相同条件下测量日本兔CVC（尖端和身体）与腔静脉内膜之间的摩擦系数（COF），观察摩擦后血管内膜的变化。研究发现，不同品牌的CVC之间的表面粗糙度存在显着差异（尖端P<0.001，体P=0.02），COF与导管表面粗糙度呈正相关（尖端P=0.005，R=0.945，体P=0.01，R=0.909）。此外,摩擦后血管内粗糙度增加。这些发现表明，CVC的高粗糙度表面可能会对中心静脉内膜造成慢性机械摩擦损伤，这是导致CVS或闭塞的潜在因素之一。这为减少并发症提供了突破，改善患者预后，和先进的导管表面润滑技术。
