导尿期间邻苯二甲酸二（2-乙基己基）酯暴露的潜在生物标志物。
The Potential Biomarker of Di(2-ethylhexyl) Phthalate Exposure during Catheterization.
作者信息
Weng Ken-Pen, Chang Wei-Hsiang, Lee Ching-Chang, Chien Kuang-Jen, Hsieh Kai-Sheng, Huang Shi-Hui
机构信息
Congenital Structural Heart Disease Center, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung.
School of Medicine, National Yang Ming Chiao Tung University, Taipei.
出版信息
Acta Cardiol Sin. 2022 Nov;38(6):691-699. doi: 10.6515/ACS.202211_38(6).20220606A.
BACKGROUND
Di(2-ethylhexyl) phthalate (DEHP) may produce toxicity, posing a risk to human health. Medical devices composed of DEHP are frequently used in catheterization, but few studies have investigated DEHP exposure during catheterization. The aim of this prospective series was to characterize the exposure pattern of DEHP during catheterization.
METHODS
We enrolled 16 patients with congenital heart disease undergoing catheterization. Collection of urine was done to measure DEHP metabolites on hospitalization, before catheterization, after catheterization, and at discharge. The following DEHP metabolites were measured: mono-(2-ethylhexyl) phthalate (MEHP), mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), and the ratio of MEHP to overall metabolites (MEHP%) was determined. DEHP exposure from polyvinyl chloride (PVC)-containing catheter and infusion systems were recorded in detail. Differences in DEHP levels before and after catheterization were analyzed.
RESULTS
Urinary levels of MEHP, MEHHP, and MEOHP significantly decreased from before catheterization to after catheterization (all p < 0.01), but did not change significantly from initial hospitalization to before catheterization. Urinary MEHP% significantly decreased from initial hospitalization to before catheterization (p < 0.001), then increased after catheterization (p < 0.001), and decreased gradually at discharge (p = 0.03). Urinary MEHP% after catheterization and at discharge was significantly positively related to the duration of using PVC-containing catheter systems. There was a significant positive correlation between urinary MEHP% and the duration of using PVC-containing infusion system before catheterization, and a borderline significant correlation at both post-catheterization time slots.
CONCLUSIONS
Our results demonstrated that urinary MEHP% may be a potential biomarker of DEHP contamination from the use of PVC-containing catheters or infusion systems.
背景
邻苯二甲酸二（2-乙基己基）酯（DEHP）可能产生毒性，对人类健康构成风险。由DEHP制成的医疗器械常用于导管插入术，但很少有研究调查导管插入术期间的DEHP暴露情况。本前瞻性系列研究的目的是描述导管插入术期间DEHP的暴露模式。
方法
我们纳入了16例接受导管插入术的先天性心脏病患者。在住院时、导管插入术前、导管插入术后及出院时收集尿液以测量DEHP代谢物。测量以下DEHP代谢物：单（2-乙基己基）邻苯二甲酸酯（MEHP）、单（2-乙基-5-羟基己基）邻苯二甲酸酯（MEHHP）和单（2-乙基-5-氧代己基）邻苯二甲酸酯（MEOHP），并确定MEHP与总代谢物的比例（MEHP%）。详细记录了含聚氯乙烯（PVC）导管和输液系统的DEHP暴露情况。分析了导管插入术前和术后DEHP水平的差异。
结果
从导管插入术前到术后，尿液中MEHP、MEHHP和MEOHP的水平显著下降（均p<0.01），但从最初住院到导管插入术前没有显著变化。尿液MEHP%从最初住院到导管插入术前显著下降（p<0.001），然后在导管插入术后增加（p<0.001），并在出院时逐渐下降（p=0.03）。导管插入术后及出院时尿液MEHP%与使用含PVC导管系统的持续时间显著正相关。导管插入术前尿液MEHP%与使用含PVC输液系统的持续时间之间存在显著正相关，在导管插入术后的两个时间段均存在边缘显著相关性。
结论
我们的结果表明，尿液MEHP%可能是使用含PVC导管或输液系统导致DEHP污染的潜在生物标志物。
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