Effects Of Ulinastatin On Inflammatory Response To Cardiopulmonary Bypass In Cardiac Valve Replacement Surgery

Objective: To investigate the effects of ulinastatin on the systemic 1inflammatory response and postoperative cognitive dysfunction (POCD) in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB). Methods: Forty ASAⅡorⅢpatients of both sexs, ages30~50Yr, Weight 45~68Kg, scheduled for cardiac valve replacement, were randomly divided into 2 groups (n=20 each): control group (group C) and ulinastatin group (group U). Ulinastatin 10000u/kg was injected iv before operation, and ulinastatin 10,000u/kg was added to the priming fluid in group U. The equal volume of normal saline was given in stead of ulinastatin in group C. Venous blood samples was taken before CPB, at the end of CPB, two hours after CPB, six hours after CPB, twenty hours after CPB. The concentration of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and S-100βprotein in plasma level were measured.To observe the change of postoperative serum S-100βconcertration and the incidence of postoperative cognitive dysfunction (POCD). Results: TNF-α, IL-6, and S-100βprotein in the treated groups were lower than those in the control group at the end of CPB, 2 hours CPB and 6 hours after CPB (P<0.01). Conclusion: Ulinastatin can attenuate cerebral injury during cardiac valve replacement with CPB. The decrease in proinflammatory cytokines and a lower rate in patients with POCD.