Effects Of Ulinastatin And Methylprednisolone On Inflammatory Response In Patients Undergoing Cardiopulmonary Bypass

Objective To compare the effects of ulinastatin and methylprednisolone on inflammatory response in patients undergoing cardiopulmonary bypass(CPB).Methods Sixty ASA Ⅲ or Ⅳ,NYHAⅡ or Ⅲ patients of both sexes,aged 40-64 yr,weighing 50-75 kg,scheduled for cardiac valve replacement under CPB,were randomly divided into 3 groups(n=20each) : ulinastatin group(group U), methylprednisolone group(group M) and control group(group C).Ulinastatin1.2×104U/kg was injected in group U, methylprednisolone 2.5mg/kg was given in group M and the equal volume of normal saline was given in group C.3ml of venous blood samples was taken before CPB(T1)、1h of CPB(T2)、1h(T3)、6h(T4)、24h(T5)and 48h(T6) after termination of CPB for determination of plasma concentration of IL-6、TNF-α and IL-10 by ELISA. Results In those three groups, the plasma levels of IL-6 and TNF-α were significantly higher than the baseline values(T1)during and after CPB(p<0.01), but there were no significant differences between T6 and T1.For IL-10,the plasma levels from T2~T4 were higher than T1(p<0.01),and there were no significant differences among T5 、 T6 and T1.The peak levels of IL-6 、 TNF-αand IL-10 shown at T3,and then decreased slowly to the baseline level.Compared with the control group,the plasma levels of TNF-α、IL-6 in both group U and group M at T2~T5 were significantly lower, and the plasma level of IL-10 at T2-T4 was higher, however, there were no significant differences between the two groups.Conclusion During the CPB, both ulinastatin and methylprednisolne can significantly inhibit the inflammatory cytokines(IL-6 、 TNF-α) release and promote the anti-inflammatory cytokine(IL-10)release, and then reduce the inflammatory response. But the effect of both drugs shows no difference.