医用介入导丝用疏水和亲水涂层的研究进展

医用介入导丝被广泛应用于各类介入手术，是目前经皮冠状动脉成形（PTCA）术及经皮血管成形术（PTA）中常用的医疗器械之一。在医用介入导丝表面添加亲水或疏水涂层，可以减小导丝在临床应用中的组织摩擦和组织损伤，有效提高导丝的通过性、抗菌性和生物相容性，减少炎症。综述了近年来国内外医用介入导丝亲水和疏水涂层材料，介绍了这些涂层的机理、附着力优化、抗菌修饰等方面内容，重点介绍了聚四氟乙烯、聚乙烯吡咯烷酮、聚丙烯酰胺、聚乙二醇、聚对二甲苯等涂层材料体系的研究进展，介绍了不同材料体系在医用导丝亲水和疏水涂层的作用机理和实际应用，同时介绍了亲疏水涂层的制备工艺，重点阐述了层层自组装、紫外光接枝、等离子体接枝和化学气相沉积等制备方法的可操作性、优势和劣势。最后在总结前人研究成果的基础上，对医用介入导丝涂层的现状及面临的问题进行了探讨，并对医用介入导丝涂层的发展方向及提高涂层综合性能等方面进行了展望。

Research Progress of Hydrophobic and Hydrophilic Coatings for Medical Interventional Guidewires

Medical interventional guidewires are widely used in various interventional procedures and are commonly used medical devices in percutaneous transluminal coronary angioplasty (PTCA) and percutaneous transluminal angioplasty (PTA). Although the size of the interventional guidewire is quite small in the whole medical device system, it is used in a large amount in clinical practice. With the rapid development of the medical device industry, medical interventional guidewires are becoming more and more common in clinical applications. The coating on the surface of medical interventional guidewires works as an important support for application promotion and function expansion. The attachment of hydrophilic or hydrophobic coating on the surface of guidewires has received extensive attention from researchers. The addition of hydrophilic or hydrophobic coatings to the surface of medical interventional guidewires can reduce tissue friction and tissue damage in clinical applications, effectively improve the passage, antimicrobial and biocompatibility of the guidewires, and reduce inflammation. The coating may peel off from the surface due to weak bonding, leading to adverse events. In recent years, there have been successive reports focusing on coating shedding, the hazards of which include residual coating debris in patients, local tissue reactions and vascular thrombosis, and can even lead to serious adverse events including embolic stroke, tissue cell necrosis and death, so a more comprehensive and rational means of surface modification is necessary to make the guide wire surface coating with good hydrophilic or hydrophobic premise, not only with good adhesion and the surface modification must be carried out in a more comprehensive manner, so that the surface coating of the guidewire not only has good adhesion and solidity, but also has good biocompatibility and antibacterial and antibacterial properties.