Myocardial Protective Effect Of Ulinastatin Pretreatment Against Ischemia/Reperfusion Injury During Cardiac Valve Operation With Cardiopulmonary Bypass

Objective:To observe the comparison of the myocardial preservation between ulinastatin pretreatment and the infusion of ulinastatin during cardiac surgery against ischemia/reperfusion injury during Cardiac valve operation with cardiopulmonary bypass.Which effect of the myocardial preservation of the opportunity of the administration is better for the patients of the extracorporeal circulation operation.Methods:The patients will be grouped into the experimental group (when the patients get in the operating room, beginning to infuse ulinastatin into the vein,according to the2WIU/kg dose, keep infusing until10min before blocking the aorta,about1hour,it is the ulinastatin pretreatment group A group) and the matched group (ulinastatin,according to the2WIU/kg dose,to be dissolved in physiological saline solution and diluted to40ml,a half of the medicine is injected into the vein slowly in the sternotomy after, before the aortic cannula. And the remaining half is injected into the flushing fluid,along with the cardiopulmonary bypass into the body B group).To observe the situation of cardiac arrest,the situation of cardioversion, the aortic cross clamping time, the parallel circulating time during the operation,the ventilator assisted breathing time after the operation,and the concentration of the cardiac troponin(cTn Ⅰ)、serum creatine kinase(CK)、creatinekinase isoenzyme(CK-MB) in1hours after opening aorta and24hours after the operation.Results:The concentration of the cardiac troponin(cTn Ⅰ)、serum creatine kinase(CK)、 creatinekinase isoenzyme(CK-MB) of the patients of the two groups is in the normal range before the cardiac surgery,the differences of the comparison of the two groups are not significant.The situation of cardiac arrest of the experimental group is the same good as the matched group,but the rate of automatic rebeating of the heart of the experimental group is higher than the matched group.The concentration of the cardiac troponin(cTn Ⅰ)、serum creatine kinase(CK)、creatinekinase isoenzyme(CK-MB) of the patients of the experimental group is significantly lower than the matched group in1hours after opening aorta and24hours after the operation.Conclusion:The myocardial preservation of ulinastatin pretreatment against ischemia/reperfusion injury during Cardiac valve operation with cardiopulmonary bypass is stronger than the myocardial preservation of the infusion of ulinastatin during cardiac surgery.