社團法人臺灣臨床藥學會

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【綜合評述】塑化劑對醫藥品影響及致癌機轉之探討
Application and Safety of Plasticizer on Medical Devices
塑化劑、鄰苯二甲酸酯、鄰苯二甲酸二(2-乙基己基)酯、聚氯乙烯、太酸單二乙基己基酯、過氧化體增殖劑活化受體α、plasticizer, phthalates esters, DEHP, PVC, MEHP, PPAPα
陳偉立Wei-Li Chen1 、施李碧玉Pi-Yu Shih Lee1,2 、陳立奇Lih-Chi Chen*3
1臺北市立聯合醫院藥劑部 、2臺北市立聯合醫院中興院區藥劑科 、3台北市衛生局藥物食品管理處
塑膠產品的使用已有悠久的歷史,應用廣泛,已是目前生活上不可或缺的物質。許多塑膠製品中都會添加鄰苯二甲酸酯類做為塑化劑,以增加彈性、柔軟度及延展性。聚氯乙烯(PVC)最便宜也最普遍,經由添加DEHP (di(2-ethylhexyl) phthalate)增加可塑性,應用於血袋、點滴管、洗腎用的透析導管及靜脈營養等塑膠醫材中,也是最容易釋出塑化劑的材質。DEP (Diethyl phthalate)及DBP (Dibutyl phthalate),作為鄰苯二甲酸醋酸纖維素的溶劑及塑化劑,用以製作腸溶錠及緩釋劑型藥物的包膜,防止藥物被胃酸破壞,而到達腸道吸收。鄰苯二甲酸酯類是一種環境荷爾蒙,會影響人類生殖功能,並有可能導致癌症。本文深入探討塑化劑在醫學上的應用、作用機轉、對人類健康的影響、導致癌症可能機轉。
 
Plasticizers are added to the polyvinyl chloride plastics to facilitate processing and increase flexibility and toughness in the production of a wide array of medical devices. Major medical uses of PVC include blood and plasma bags, enteral feeding and dialysis equipment. DEHP leaches into solutions stored in PVC medical devices. DEP and DBP are used in the pharmaceutical field as a constituent of the enteric coating of some medications. In this study, we review the uses and metabolism of phthalates, mechanical on phthalates-induced carcinogenicity and on health effects in human populations.
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