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I/ Tng quan v vt liu polymer y sinh 1
II/ Phn loi vt liu polymer y sinh 3
III/ ng dng ca vt liu polymer y sinh 10
NHN XT 22
TI LIU THAM KHO 23












Vt liu polymer y sinh Page 1

I/ Tng quan v vt liu polymer y sinh:
1/ Khi nim:
Polymer y sinh l vt liu polymer (c ngun gc thin nhin, nhn to, hoc
tng hp) c s dng trong y hc vi mc ch iu tr, thay th c quan hay
chc nng, hoc tng cng chc nng no trong c th ngi v ng vt[1].
Mc d polymer y sinh c ng dng ch yu trong lnh vc y hc, nhng
n cng c th c s dng rng ri trong cc lnh vc khc nh: cng ngh sinh
hc, mi trng, nng-lm-ng nghip.
2/ Cc yu cu i vi vt liu polymer y sinh:
Tt c cc vt liu polymer y sinh phi p ng y 4 yu cu c bn sau y[1-
3]:
Tnh tng hp sinh hc v khng c hi:
Vt liu polymer phi thch ng vi cc m, t bo ni vt liu tip xc; c
kh nng kch thch s ha hp vi cc m ny. Khng gy sc phn v vi c th
sau khi cy ghp cc vt liu ny trong thi gian di. S xut hin phn ng vim
khi a vt ghp vo c th l hin tng t nhin khi c vt l vo c th, trong
trng hp vt liu c tnh tng thch sinh hc cao th hin tng vim do phn
v s ht thc trong vi ngy; trong trng hp vt liu khng c tnh tng thch
sinh hc vi m tip xc, hin tng vim ko di do c th thc hin phn ng
phn v o thi vt ghp ra ngoi c th.
Vt liu polymer phi th hin tnh khng c hi khi thc hin chc nng
trong sut qu trnh s dng trong c th bo m tnh an ton trong qu trnh
s dng.
Tnh c th kh trng:
Tt c cc vt liu cy ghp phi c kh trng trc khi thc hin cy ghp.
Cc phng php kh trng thng thng c s dng l: Tia gama, plasma, tia
cc tm; cn, v nhit . Cc vt liu ny phi khng b thay i tnh cht, hnh
dng v cu trc khi s dng mt trong nhng phng php kh trng trc khi
a vo c th bo m tnh nng ca chng.
Vt liu polymer y sinh Page 2

Tnh chc nng:
Mi mt loi vt liu polymer y hc c dng thay th, cha tr phi c
mt chc nng c bit ph hp vi mc ch s dng ca n. i khi cc nh
khoa hc c th kt hp nhiu loi vt liu khc nhau p ng chc nng, nhim
v ca b phn cn thay th.
Tnh c th ch to:
Vt liu polymer phi c kh nng c ch to theo hnh dng v kch thc
yu cu. Nhiu trng hp vt liu polymer p ng c cc yu cu trn nhng
khng th ch to nn khng c kh nng ng dng trong y sinh.
* Ngoi nhng yu cu c bn trn, cn c mt s yu cu c th khc ty theo
tng trng hp s dng v mc ch s dng c th nh:
- Tnh khng phn hy v bn trong mi trng sinh hc: i vi mt s
trng hp yu cu p ng chc nng trong thi gian di nh: cc ng dn lu,
xng, khp.
- Tnh phn hy sinh hc: i vi cc trng hp vt liu p ng chc
nng trong thi gian c hn nh: vt liu khung (scaffold) dng nui cy pht
trin mt t bo no ; vt liu truyn dn dc phm trong c th.
3/ Tnh hnh ng dng v nghin cu vt liu polymer y sinh ti Vit nam:
Trong nhng nm gn y, nn khoa hc v y t ca Vit Nam c nhng
bc tin rt ng k. Nhiu thit b v cng ngh khm cha bnh hin i ngang
tm th gii c nhp khu v Vit nam. c bit, i ng y bc s trong nc
cng dn c o to nhiu nc tin tin trn th gii v dn khng nh v tr
khoa hc ca mnh trn bn th gii.
T nhng s tin b trn, vic s dng cc sn phm y t t polymer y sinh
ti Vit nam rt pht trin. Hu nh mi sn phm tin tin nht v mt khoa hc
u c ti Vit nam. Trong nhng nm gn y, rt nhiu sn phm y t xut pht
t polymer y sinh c s dng[14]:
- Hng ngn ngi c t stent ng mch vnh.
- Hng ngn ngi thay khp hng trong nc v nc ngoi.
Vt liu polymer y sinh Page 3

- Hng triu ng ng mch cc loi c s dng mi ngy, trong c
khng t cc loi stent t trong c th.
- Cc ca chn thng, chnh hnh nghim trng cn s dng cc vt t y t t
polymer y sinh din ra hng gi trn khp c nc.
- Hng trm ngn ngi mc bnh him ngho cn iu tr bng phng php vn
chuyn v truyn dn thuc hin i.
Tuy nhin, mt iu cn lu l a s tt c cc sn phm vt t, thit b y
t k trn u c nhp khu t nc ngoi.



II/ Phn loi vt liu polymer y sinh:
n thi im hin ti, c rt nhiu loi sn phm t polymer y sinh c
nghin cu v ng dng gp phn khng nh vo vic cha bn v phc v cuc
sng con ngi, v c h thng di dy:
1/ H vt liu polymer y sinh thay th cho xng, khp, gn:
Hin c rt nhiu h vt liu i t polymer y sinh c s dng trong vic
thay th v iu tr vi mc ch ny nh c trnh by nh di y[4-5]:

- Cc loi si: CF (carbone fiber), C (carbone), GF (Graphite fiber); UHMWPE
(ultra hight molecular weight Polyethylene); PGA (Polyglicolide); KF (Kevlar
fiber),
- Cc loi polymer: UHMWPE (ultra hight molecular weight Polyethylene); PGA
(Polyglicolide); PLLA (Poly L- lactide); PCLA (poly-caprolactone co-L-Lactide);
PCL (poly caprolactone); PET (polyethylene terephthalate); PTFE (polytetra floro
ethylene); epoxy, PMMA (polymethyl methacrylate),

Vt liu polymer y sinh Page 4



Cc vt liu t polymer y sinh c cha tr v thay th cho h xng, khp,
gn
Cc loi vt liu cho h xng, gn, khp:
Vt liu polymer y sinh Page 5

Cc loi sn phm s dng:
- Cc loi nh v: c vt nh v , thanh nh v.
- Cc loi thay th: khp hng, xng du gi, a m, xng sng,
- Cc loi b xung: rng, polymer tram rng,

2/ H vt liu polymer y sinh s dng lm h dn lu[4-6]:
i vi cc sn phm dn lu th c th chia lm hai loi theo thi gian s dng:
S dng ngn hn:
Cc loi ng dn lu ny thng ch c s dng trong thi gian rt ngn,
sau b i nh: ng truyn v dn dch, nc, mu, cc loi ng thng, Cc
loi ng ny thng khng tip xc hoc tip xc hn ch vi c th v a s l
nm ngoi c th. V vy, cc loi ng ny thng s dng vt liu t PE, PVC l
ch yu.
S dng di hn:
Cc loi ng dn lu ny thng c s dng trong thi gian cng di cng
tt nh: ng thng mt, cc stent ng mch, Stent bang quang, Cc loi ng
ny thng tip xc vi cc m trong c th v a s l nm trong c th. V vy,
cc loi ng ny thng s dng vt liu c cht lng v bn hoc tnh tng
thch sinh hc cao nh PTFE, UHMWPE, PCLA, PLLA.

3/ H vt liu polymer y sinh s dng lm khung xng (scaffold)[5-7]:
Hin nay, h vt liu scaffold t polymer y sinh phn hy sinh hc c s dng
rt nhiu trong vic nui cy v pht trin t bo gc c chc nng chuyn bit.
Scaffold t polymer y sinh ny s lm ga th cc t bo pht trin trn , khi
hnh dng ca b phn cn nui cy hnh thnh y th polymer y sinh cng
c phn hy ht. Kt qu l s pht trin ca cc t bo ny s hnh thnh v
Vt liu polymer y sinh Page 6

thay th y cc b phn ca c th b khim khuyt (c bit l cc b phn
ny l hnh thnh t t bo sng ch khng phi l mt vt liu cht).
Cc loi polymer y sinh phn hy sinh hc c s dng lm scaffold l: PCLA,
PLLA, PLA, PGA, PCLA,
Cc t bo gc v cc b phn c th thay th l: Rng, xng, sn, da, .

4/ H vt liu polymer y sinh phc v chun on[3-5]:
Mt trong nhng lnh vc cc k quan trng trong ngn y hc l chun on v
xt nghim, hin c rt nhiu polymer c tnh nng c bit nh polymer dn in,
polymer nhy cm vi cc yu t mi trng nh: nng protein, ng, pH,
in, t trng, .. c kt hp vi cc loi vt liu khc nh CNT, kim loi nano
nh Vng, Bc, oxite st t, ch to cc h thit b, sensor v dng c chun
on bnh bng hnh nh, in s, mu sc, vi chnh xc rt cao v tin li.
cc h thit b ny gip cho vic chun on v cha tr c thc hin mt cch
nhanh chng v tit kim.

5/ H vt liu polymer y sinh cho vic vn chuyn v truyn dn thuc[8-13]:
Lnh vc t dc mang thuc:
Hin nay, lnh vc tng hp polymer y sinh dng t dc phc v cho vic
ch to cc loi vin nang nn, vin nang con nhng trn th gii ang to ra mt
ngun thu cc ln. Mc d cng ngh tng hp cc loi polymer ny c trin
khai i tr trn th gii, nhng ti Vit nam, cc cng ty dc phm ch nhp
polymer v ch to sn phm m cha ch trng ti vic tng hp ra loi
polymer.
Lnh vc truyn dn thuc iu tr trng ch:
Trong nhng nm gn y s pht trin ca cc cn bnh him ngho nh HIV-
AIDS, ung th, vim gan, c bit l bnh i tho ng ang tr thnh mt mi
nguy him i vi sc khe loi ngi. V chng tr thnh mt mi lo ngi v
cng ln ca cc t chc y t th gii. Vic kim sot qu trnh phn phi
Vt liu polymer y sinh Page 7

thuc/protein iu tr nhng cn bnh nghim trng trn l mt trong nhng th
thch trong lnh vc Y dc. Hin c nhiu loi dc phm (thuc /protein) chng
t c kh nng cha bnh tt, tuy nhin cc phng php s dng dc phm
truyn thng nh ung, tim, x tr, ha tr th hin s gii hn nht nh trong qu
trnh s dng. Tuy nhin, cc phng php s dng dc phm truyn thng
iu tr cc loi bnh ny c nhng nhc im ln nh: s tp trung t ngt ca
thuc/protein ti mt im, lc thuc/protein tr thnh cht c hi cho c th
bi v s tp trung lm cho liu lng thuc/protein ti cao hn bnh
thng; V dc phm dc dn truyn theo ng mu, ch khi gp t bo mm
bnh (ung th) th mi th hin chc nng cha tr, nhng trong qu trnh vn
chuyn dc phm ny cn tc dng ln tt c cc t bo khc m n gp. Do
ch c mt lng nh dc phm c tc dng hu hiu cho vic iu tr, cn phn
ln dc phm li to ra cc phn ng ph khc trong qu trnh iu tr; Thm vo
, s suy gim hnh thc (profile) ca thuc/protein n di khong liu dng
trong qu trnh iu tr i hi mt liu thuc/protein mi. Phng php s dng
polyme y sinh c cu trc nano particle nhy cm vi nhit v pH, hoc nhy
cm vi nhit hoc pH hin c cc nh nghin cu trn th gii nhn nh l
phng php phn phi thuc mt cch t nhin v c trin vng nht bi v n
cho php phn phi cc phn t hot ng ca thuc mt cch y v hiu qu
v n mang nhng u im ni tri sau:
S dng polyme y sinh c th mang v phn phi dc phm vo c th con
ngi theo nhng chng trnh c vch sn. Nh vy, nng dc phm trong
mu v thi gian tc dng ca thuc c th iu khin mt cch d dng nhm
trch hin tng cc b nht thi (hm lng dc phm trong mu cao nht thi
gy tc dng ph) v c th ko di thi gian iu tr cho mt ln s dng thuc.
So snh v hiu nng s dng iu tr ca phng php mi ny so vi cc
phng php truyn thng c th hin trn hnh sau:
Vt liu polymer y sinh Page 8


Hnh thc kim sot thuc/protein
- ng t khc: Hnh thc nh thuc/protein theo phng php truyn thng,
phi s dung lp li nhiu ln.
- ng lin nt : Hnh thc nh thuc lin tc t hydrogel y sinh. Ch s dng
mt ln.

Cu trc mng li polyme hydrogel c sp xp vi cc tnh cht ho l
d dng tng tc vi dc phm. H polyme y sinh, c bit l hydrogel y sinh
ang c ch trng trong vic ng dng vo phng thc cha bnh mi, bi v
chng c nhiu u im nh kh nng tng thch sinh hc tt, tnh tng tc vi
dc phm c th kim sot . Mt u im quan trng ca phng thc phn phi
thuc t hydrogel l chng c th kim sot c bi mt vi yu t, v d nh :
Kch thc l trng ca hydrogel, tnh k nc, s c mt ca mt s nhm chc
c bit, chng to ra mt tng tc c trng gia cht mang (matrix) vi thuc
v s kim sot phn hu ca cc hydrogel y sinh.
Vt liu polymer y sinh Page 9


C ch hnh thnh hydrogel t polyme y sinh c cu trc nano
particle nhy cm vi nhit v pH khi tim vo c th sng

Mc d tng a ra c nhng bc t ph trong khoa hc, v cc nh
khoa hc trn th gii ang tp trung nghin cu theo hng i ny, tuy nhin
cng ch l nhng bc u nghin cu v cha c mt ng dng c th no do
nhng nguyn nhn sau: Vn tng hp ra loi polymer phi c cu trc thch
hp vi nhng iu kin thay i v pH v nhit trong c th cn gp kh khn;
Loi polymer phi c kh nng khng c hi, tnh tng ng sinh hc cao
(khng b phi ng o thi khi a vo c th ngi) v c kh nng phn hy
sinh hc. V nhng l do trn, hin th gii vn ang n lc nghin cu v ngi ta
d on kh nng p dng cc nghin cu ny s bt u c th trin khai trong
tng lai 5 nm sau.





Vt liu polymer y sinh Page 10

III/ ng dng ca vt liu polymer y sinh:
1/ ng dng vt liu nano chitosan trong truyn dn thuc:
Tng quan v chitosan:
Chitosan l mt loi polymer carbohydrate t nhin c th to ra bng cch
deacetyl ho chitin. Chitosan c th tm thy trong t nhin t ng vt gip xc
nh tm, cua. Chitosan cn c th c tm thy t nhng loi vi sinh vt nh
nm, men.
Chitosan l dn xut deacetyl ho ca chitin, trong nhm (NH2) thay th
nhm (-NHCOCH3) v tr C2. Chitosan c cu to t cc mc xch
D-glucosamine lin kt vi nhau bi lin kt -(1-4)-glycoside[15][16].

Cng thc cu to ca chitosan

Chitosan c nhng tnh cht sau:
- Khng c, tnh tng ng sinh hc cao v c kh nng phn hu sinh hc
nn khng gy d ng v khng gy phn ng ph, khng gy tc hi n
mi trng.
- Cu trc n nh.
- Tan tt trong dung dch acid long (pH < 6,3) v kt ta nhng gi tr pH
cao hn, ha tm trong dung dch iod.
- C tnh khng khun tt.
Vt liu polymer y sinh Page 11

- L hp cht cao phn t nn trng lng phn t ca n gim dn theo thi
gian do phn ng t ct mch. Nhng khi trng lng phn t gim th hot
tnh khng khun v khng nm khng b gim i.
- C kh nng hp ph cao i vi cc kim loi nng.
- pH < 6,3, chitosan c tnh in dng cao.
- Trong phn t chitosan c cha nhm OH, -NHCOCH3 trong cc mt xch
N-acetyl-D-glucosamine c ngha chng va l alcol va l amine, va l
amide. Phn ng ho hc c th xy ra v tr nhm chc to ra dn xut th
O-, dn xut th N-.
- Mt khc chitosan l nhng polymer m cc monomer c ni vi nhau
bi cc lin kt -(1-4)-glycoside; cc lin kt ny rt d b ct t bi cc
cht nh: acid, baz, tc nhn oxy ho v cc enzyme thu phn[15][16].
Tng quan v nano chitosan:
Chitosan c s dng lm nguyn liu iu ch ht nano chitosan trong
nhng nm gn y v nhng tnh cht u vit ca n kch thc nano. Chitosan
l dng deacetyl ha t chitin, c cu trc polysaccharide, c tm thy loi
ng vt gip xc, cn trng v mt vi loi nm. Vi nhiu tnh nng nh tnh
tng thch sinh hc, phn hy sinh hc, bm dnh mng v khng c hi, n tr
thnh nguyn liu cho nhiu ng dng dc sinh hc. Do , ht nano chitosan tr
thnh h thng phn phi thuc c tim nng ln[17].
Nano chitosan do c kch thc siu nh (t 10 n 1000nm) nn d dng i
qua mng t bo, c th a vo c th qua nhiu ng khc nhau nh dng
ngoi da, dng qua ng ming, qua mi. Nano chitosan c din tch v in
tch b mt cc ln nn c ng dng nhiu trong sinh y hc nh mang thuc,
vaccine, vect chuyn gen, chng khun, thuc iu tr ung th. Khi s dng
nano chitosan lm cht dn thuc, thuc iu tr c bo v bi nhng ht nano
chitosan khi s phn hu sinh hc. Do kch thc rt nh, nhng ht ny c tc
dng thm su vo c th, a thuc n ng mc tiu, nng cao hiu qu iu
tr[18].
Cc phng php ch to nano chitosan:
Hin nay c nhiu phng php to nano chitosan. Phng php c s dng
nhiu nht l to gel ion, u im ca phng php ny l qu trnh chun b n
Vt liu polymer y sinh Page 12

gin v khng cn phi s dng dung mi hu c hay s dng lc nn ln, do
phng php ny c nghin cu rng ri trong tng hp cht dn thuc v thc
phm chc nng[18].
Nhng yu t nh hng n tnh cht ht nano chitosan nh kch thc ht v
s tch in b mt l khi lng phn t v deacetyl ho ca chitosan. Hiu
qu thu gi thuc ca ht nano chitosan ph thuc vo gi tr pKa v ho tan
ca thuc. Thuc kt hp vi chitosan qua tng tc tnh in, lin kt hidro,
[18]. S la chn phng php tng hp nano chitosan cn ph thuc vo bn
cht ca nhng phn t hot ng cng nh nhng yu cu dn truyn khc nhau.
1.1: Phng php khu mch nh tng:
Hn hp nh tng nc trong du (w/v) c to ra bng cch phn tn dung
dch chitosan trong du. Nhng git lng c lm bn bi cht hot ng b mt.
Dung dch nh tng sau c khu mch bng tc nhn to ni thch hp nh
glutaraldehyde. Hai nhm CHO ca glutaraldehyde s phn ng vi nhm
NH2 ca chitosan khu mch to ht nano chitosan[19].

Vt liu polymer y sinh Page 13

1.2: Phng php git t/kt ta:
Phng php ny s dng tnh cht ca chitosan l khng tan trong dung
dch kim. Bi vy, chitosan s b kt ta, to git ngay khi dung dch chitosan tip
xc vi dung dch kim. Dung dch kim c th l NaOH, NaOH-metanol hoc
ethandiamine. Dung dch chitosan s c mt thit b nn phun vo dung dch
kim to ht nano[19].

1.3: Phng php hp nht git nh tng:
Phng php ny ln u c s dng vo nm 1999. Phng php ny s
dng nguyn tc ca c hai phng php: to ni ngang nh tng v kt ta. Thay
v s dng tc nhn to ni ngang, kt ta to ra bng cch cho cc git chitosan
kt hp vi cc git NaOH. Mt h nh tng bn cha dung dch chitosan cng
vi thuc to ra trong paraffin lng. ng thi, mt h nh tng bn khc cha
dung dch chitosan v NaOH cng c to ra theo cch nh trn. Khi c hai h
nh tng ny c trn li vi tc khuy cao, cc git t mi h s va chm
mt cch ngu nhin, hp li v kt ta thnh nhng ht nh[19].
Vt liu polymer y sinh Page 14



1.4: Phng php to gel ion:
C ch ca phng php ny da trn tng tc tnh in gia chitosan tch
in dng v mt polyanion nh tripolyphosphate. K thut ny c u im l
giai on chun b n gin v thc hin trong mi trng nc. u tin chitosan
c ha tan vo dung dch acid acetic. Sau chitosan c trn ln vi
polyanion to ht nano chitosan di iu kin khuy t lin tc ti nhit
phng. Kch thc v in tch b mt c th kim sot bng cch s dng nhng
t l chitosan v polyanion khc nhau[19].
Vt liu polymer y sinh Page 15



1.5: Phng php mixen o:
Trong phng php ny, ngi ta ha tan cht hot ng b mt vo dung
mi hu c to ra nhng ht mixen o. Dung dch lng cha chitosan v thuc
c thm t t vi tc khuy khng i trnh lm c dung dch. Pha lng
c gi sao cho hn hp tr thnh pha vi nh trong sut. Sau tc nhn to ni
ngang dc thm vo v khuy qua m. C quay loi dung mi. Phn cn li
phn tn li trong nc. Dung dch mui thch hp c thm vo kt ta cht
hot ng b mt. Hn hp c ly tm. Phn dung dch trn cha ht nano
mang thuc c chit ra, cho qua mng thm tch 1 gi. ng c cht lng thu
c cho ta bt thuc[19].
Vt liu polymer y sinh Page 16



ng dng trong truyn dn thuc ca ht nano chitosan:
Ht nano chitosan c kch thc nh nn n thch hp cho nhiu con ng s
dng thuc khc nhau nn c phn loi theo con ng s dng:
- S dng bn ngoi ng tiu ha:
Cc ht nano c th c dng trong tnh mch bi v ng knh ca cc mao
mch mu nh nht l khong 4m. S phn b sinh hc ca cc ht nano c th
thay i ty thuc vo kch c, in tch b mt v tnh k nc ca chng. Cc ht
c bn knh ln hn 100nm s b hp thu nhanh chng bi h li-ni m trong
gan, l lch, phi v ty xng. Ngc li, nhng ht nh hn c xu hng c thi
gian lun chuyn ko di[18].
Cc loi thuc ha hn nht c nghin cu rng ri dn truyn theo
cch ny l nhng tc nhn khng ung th. Sau khi tim vo tnh mch, nhiu h
thng ht nano bao gm nano chitosan c xu hng tch ly li trong mt s khi u
Vt liu polymer y sinh Page 17

(Brasseur, 1980; Kreuter, 1994). Nhng ht nano chitosan mang doxorubicin lm
chm s tng trng ca khi u v nng cao t l sng st ca nhng con chut b
cy khi u. Ngoi ra, nhng ht nano chitosan c kch thc nh hn 100nm c
to ra cho thy trnh khi h li-ni m v lun chuyn trong mu c lu
hn[18].
- S dng qua ng ung:
tng ht nano c th bo v thuc khng b enzyme phn hy trong b my
tiu ha dn n s pht trin cc ht nano thnh nhng h thng dn truyn nhng
phn t ln, protein v polynucleotide. Phng php ny c nghin cu rng ri
sau mt bo co rng lng ng trong mu ca nhng con chut mc bnh tiu
ng gim sau khi ung nhng ht nano insulin (Damge,1990). Kch thc ht
nh hn 500nm l mt yu t then cht cho php vn chuyn qua nim mc rut
theo c ch endocytotic. Bn cnh enzyme, mng nhy ngn cn s khuych tn
ca thuc v ht nano, nhng ro cn hp th biu m l chng ngi chnh chng
li s hp th thuc protein qua thnh rut. Do , hot tnh ca thuc c th c
ci thin bng cch kim sot kch thc ht cng vi ko di thi gian lu gi
thuc trong b my tiu ha. Trong s nhng ht nano polymer, ht nano chitosan
l cht dn thuc l tng v chng lm tng mc hp thu thuc[18].
Kh nng ci thin mc hp thu ca chitosan c nghin cu rng ri. c
tnh bm dnh ca chitosan l do tng tc gia chitosan tch in dng v nim
mc tch in m. iu ny lm ko di thi gian tng tc ca thuc v b mt
hp th[18].
- S dng qua ng mt:
Cc ht nano c nhn thy l cht mang tim nng dn truyn qua ng
mt. Nhiu th nghim cho thy ht nano c khuynh hng bm cht vo b mt
biu m mt. Kt qu ko di thi gian lu gi, tc o thi thuc chm hn so
vi nhng phng php iu tr mt truyn thng, do ci thin dc tnh ca
thuc. V vy, nhng ht nano c dng dn thuc khng vim, khng d
ng cho nhng mc tiu iu tr vim mt[18].
Chitosan c s dng nh l cht mang dn thuc iu tr chng vim mt
bi v tc ng thc y mc hp thu thuc. Chitosan khng ch gia tng thi gian
Vt liu polymer y sinh Page 18

tng tc vi gic mc qua tng tc tnh in gia in tch dng ca n v
nim mc tch in m, n cn c kh nng xuyn qua lp nim mc, nng cao
dc tnh ca thuc. Nhm ca Felt (1999) tm thy dung dch chitosan ko di
thi gian lu gi thuc khng sinh trn gic mc ca th. Nhng tc ng tng t
cng c quan st thy khi s dng nhng ht nano chitosan. Nhng ht ny c
gi trn gic mc v kt mc ca th t nht 24 gi. Nhm ca De Campos (2001)
pht hin thy sau khi s dng nhng ht nano chitosan trn th, hu ht thuc
c tm thy trong nhng m ngoi mt, gic mc v kt mc trong khi ch mt
lng thuc nh c tm thy trong nhng m trong mt, mng mt v cht dch
lng[18].


2/ Vt liu sinh hc to khung (Scaffold) trong k ngh m:
K ngh m (Tissue engineering) l mt lnh vc lin quan n ng dng
cc nguyn tc v cc phng php k ngh v khoa hc s sng hng ti hiu
bit c bn cc mi quan h cu trc chc nng ca cc m ng vt c v bnh
thng v bnh l pht trin cc vt thay th sinh hc m khi phc, duy tr
hoc ci thin chc nng ca m. Mc tiu ca k ngh m l khc phc nhng
hn ch ca cc phng php iu tr truyn thng da trn cy ghp c quan v
vt liu sinh hc[20].
Cc c tnh l tng ca scaffold:
- C cu trc l xp bn trong (ng knh l t nht 60 - 100m): tng
trng m, phn b mch, cung cp dng cht.
- c ch to t vt liu c kh nng phn hy sinh hc hoc kh nng hp
thu sinh hc c kim sat m s thay th scaffold.
- C ha hc b mt thch hp gip cc t bo bm, bit ha v tng sinh.
- C cc c tnh c hc thch hp tng xng vi vng ghp.
- Khng kch thch bt k phn ng c hi no.
- D to theo hnh dng v kch thc mong mun.
Cc vt liu scaffold:
- Cc polymer tng hp:
Vt liu polymer y sinh Page 19

Cc nghin cu s dng vt liu gm v c t nhin v tng hp (nh
hydroxyapatite v tricalcium phosphate) ch to scaffold trong k ngh m
xng do cc vt liu ny ging vi thnh phn v c t nhin ca xng v c
cc c tnh dn xng. Tuy nhin, cc gm ny c tnh gin (d gy) v khng
ph hp vi cc c tnh c hc ca xng. Xng l mt composite gm khun
nn polymer c tng cng vi cc phn t gm. Polymer l collagen v
hydroxyapatite. Hn na, scaffold gm khng thch hp cho s tng trng ca
m xp (nh m c tim) v cc m ny c cc receptor t bo v cc cc yu cu
c tnh c hc khc. Cc polymer t nhin v tng hp l la chn hp dn v
linh hat v ng dng cho s tng trng phn ln m[20].
Cc polyester nh polyglycolic acid (PGA), polylactic acid (PLLA), cc
copolymer (nh PLGA) v polycaprolactone (PCL) thng c s dng thit
k cc scaffold. Sn phm phn hy ca cc polymer ny (glycolic acid v lactic
acid) hin din trong c th ngi v c thi lai thng qua con ng trao i
cht t nhin[20].
- Cc polymer t nhin:
Cc polymer l protein hoc carbohydrate c ngun gc t nhin c s dng
lm scaffold cho s tng trng ca vi lai m. Polymer t nhin ph bin nht
c s dng to scaffold k ngh m l collagen[20].
Cc phng php ch to scaffold:
2.1: Lc gin on qua khun dung mi (solvent-casting particulate-leaching):
K thut ny bao gm to ra mt dung dch PLLA trong chloroform v thm
cc ht mui c ng knh c bit to ra mt dch huyn ph ng nht. Cho
dung mi bay hi cn li khun nn polymer vi cc ht mui khp bn trong.
Sau , ngm composite trong nc lai mui ra v cn li cu trc l xp.
2.2: Bt kh (Gas foaming):
Mt polymer c kh nng phn hy sinh hc nh l PLGA c bo ha vi
CO
2
p sut cao. Sau , lm gim nhanh kh nng ha tan ca kh trong
polymer bng cch a p sut CO
2
tr v p sut kh quyn. iu ny dn n s
to nhn v khuch trng bt kh vi kch thc 100 500 m trong polymer.
Vt liu polymer y sinh Page 20

2.3: Mng li si (Fibre meshes/fibre bonding) :
Cc si t cng nghip dt c s dng ch to scaffold t PGA v
PLLA. Tuy nhin, cc scaffold ny khng n nh v cu trc nn thng gy ra
s bin dng nghim trng do cc lc co rt ca t bo c nui trn scaffold.
iu ny dn n vic pht trin k thut lin kt si tng cng cc c tnh
c hc ca scaffold. Quy trnh nh sau: ha tan PLLA trong methylene chloride v
khun qua li PGA. Cho dung mi bay hi v sau lm nng khun vi
nhit trn im nng chy ca PGA. Khi khun PGA-PLLA ngui, lai PLLA
bng cch ha tan trong methylene chloride mt ln na. Kt qu l to ra mt
mng li cc si PGA c ni mch.
2.4: Tch pha (Phase separation):
Ha tan mt polymer tng hp c kh nng phn hy sinh hc trong phenol
hoc naphthalene v b sung thm cc phn t c hat tnh sinh hc nh alkaline
phosphatase vo dung dch. Sau h nhit thp hn to ra mt s tch pha
lng - lng v lm ngui to th rn hai pha. Lai dung mi bng s thng hoa
c mt scaffold xp vi cc phn t hat ng sinh hc bn trong cu trc.
2.5: Lm khun tan chy (Melt moulding):
Dng bt PLGA v cc vi cu gelatin c ng knh c bit lp y mt
khun Teflon. Sau lm nng khun nhit trn nhit chuyn tip thy
tinh ca PLGA cng vi dng sc p ln hn hp. Phng php ny lm cho cc
ht PLGA gn kt li vi nhau. Khi lai b khun, thnh phn gelatin c lc ra
bng cch ngm trong nc v sau lm kh scaffold. Scaffold c to ra theo
cch ny c hnh dng ca khun.
Quy trnh lm tan chy khun c bit i kt hp cc si HA ngn. S
phn b u ca cc si HA trong khp scaffold PLGA ch c th c thc hin
bng k thut khun dung mi chun b vt liu si HA, khun nn PLGA v
gelatin hoc to l bng mui, sau ng dng quy trnh lm khun tan chy.
2.6: Lm kh lnh:
Ha tan cc polymer tng hp nh PLGA trong acid acetic lnh hoc benzen. Sau
lm ng lnh dung dch v lm kh lnh to ra khun nn l xp.
Vt liu polymer y sinh Page 21

Tng t, cc scaffold collagen cng c ch to bng cch lm ng
lnh dung dch collagen v sau lm kh lnh. S ng lnh dung dch s lm
hnh thnh cc tinh th m s p v tp trung cc phn t collagen vo cc
khang khe. Sau , lai cc tinh th bng cch lm kh lnh. C th kim sat
kch thc l theo tc ng lnh v pH, tc ng lnh nhanh to ra cc l
nh hn. Dng ethanol kh nc ca collagen ng lnh v lm kh ti im
ti hn to scaffold collagen. Sau , cc scaffold ny c khu mch bng tc
nhn vt l hay ha hc gim kh nng ha tan, tnh khng nguyn v tc
phn hy.
Cc phng php khu mch vt l gm chiu tia UV, chiu x tia gamma
hoc phng php nhit lai hydro.
Cc phng php khu mch ha hc lin quan n vic s dng cc tc
nhn hai chc nng nh glutaraldehyde (GTA) v hexamethylene diisocyanate
hoc bng phng php hat ha nhm carboxyl vi carbodiimide. Cc polymer t
nhin khc nh chitin v alginat cng c dng ch to scaffold bng phng
php lm kh lnh.
2.7: c khun dung dch (Solution Casting):
Ha tan PLGA trong chloroform, sau ta bng cch thm methanol vo.
Xng lm kh lnh c kh khang c th kt hp vi PLGA, v sau vt
liu composite c p vo khun, lm nng n 45 48
o
C trong 24 gi to
scaffold.







Vt liu polymer y sinh Page 22


NHN XT

Qua bi tiu lun ta thy c u th vt trt ca vt liu polymer y sinh
v tim tng to ln ca vt liu ny khi ng dng vo y hc.
Ngoi ra, c th d dng nhn thy rng: lnh vc nghin cu vt liu
polymer y sinh ti Vit nam vn cn rt mi. l mt thch thc i vi nn
khoa hc nc nh. Mc d vy, tim nng v c ti chnh v nhn lc s tham gia
vo lnh vc ny cc k ln.















Vt liu polymer y sinh Page 23

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