| Object: Since Kirlinden performed that cardiopulmonarybypass resulted in systemic inflammatory response syndrome ateightieh ages in twenty centurys, the reserch that protect thebody's function destoryed with CPB were contious, and useddrugs to prevent the inflammatory response was a confirmedmethod. Endocrine and aprotinin were used widely in CPB toanti-inflammatory.Recently, a new tropism inhibitor–ulinastatinabstracted from urine of health adult men have used in CPBcardiac operation,receiveing safely and confiredanti-inflammatory and body protect role.This study wasdesigned to dynamic observe the change of the TNF-αand il-10and IL-8 concentration among four groups,evluating the bodyprotect effect in CPB cardiac operation and the clinic use.Methods: 44 randomly allocated paediatric patientsundergoing open heart operation with cardiopulmonary bypassin cardiac surgery department of The Fourth hospital of HeBeiMedical University were studied.The all patients devided intofour groups:a control group,(C group),aprotinin group(Agroup),ulinastatin 10000 unit/kg(U1 group) and ulinastatin20000 unit/kg(U2group).Blood samples were taken from arteryat three times intervals:before CPB,at the end of CPB and twohours after termination of CPB.The Hct was performed by bloodcell counter.The plasma TNF-ɑ,IL-10 and IL-8 concenationdetermined by enzyme-linked immnuosorbent assays.Resultsare presented asx±s.The statistical analysis was performedby using the Statistical Package for Social Sciencessoftware(SPSS10.0). To analysis the difference within the samegroup at different time,we used one-way ANOVA ,and usedtwo-way ANOVA between dofferent groups at the same time.Pvalue<0.05 was considered statistically significant.Results:1 Almost all of the patients occured SIRS among some timethrough monitored the temperature ,heart rate ,breath rate andcount white cell,the major changes was tempature and heart rate.2 The plasma TNF-ɑ,IL-10 and IL-8 value began to elevatesignificantly after CPB and continually elevated at two hoursafter termination of CPB.The control group's pro-inflammatorycytokine value (TNF-ɑ,IL-8)was the highest,and reached thepeak value at T3:TNF-α(66.47±18.24),IL-8(28.32±7.74),theanti-inflammatory cytokine (IL-10)value was the lowest amongfour groups at T3: IL-10(32.17 ±10.84).The U2 group'spro-inflammatory cytokine(TNF-ɑ,IL-8) value were the lowestamong four groups, and the value at T3 was: TNF-α(39.03±12.86),IL-8(20.32±5.03), the anti-inflammatory cytokine(IL-10)value was the highest among four groups at T3: IL-10(50.92±12.36).The data of A group and U1 group was between theabove two groups.There were statistically significant (P<0.05 orP<0.01)between the other three groups and the C group .AtT3,the IL-10 peak value correlated positively with TNF-α(r=0.740,P<0.01),and also correlated positively withIL-8(r=0.625,P<0.05).3 There were no statistically significant (P>0.05)of not onlyCPB time but also aorta blocked and operation time among thefour groups,and the same were the stayed hospital days and flowamount after operation(P>0.05).4 There was a allergic incident occurred in A group,but the Ugroup and C group had no the same enents.Conclusions:1 Through monitored the patient's temperature,heart rate, andcounted white cell after operation,SIRS haved occurred inalmost all of the patients.These means CPB motivated hugedestory in bodies.The change of the plasma TNF-α,IL-10 andIL-8 value also indicated that the inflammatory response andanti-inflammatory response to CPB occurred at the sametime ,and the more serious inflammatory response was,the moreserious anti-inflammatory was,the more body functions wasdestoried.2 As widely used tropism inhabitors–aprotinin and ulinastinincan inhibited the inflammatory,elevating anti-inflammatorycytokine level at the same time,and the effect was moresignicent with high dose ulinastinin.The allergic incident may beoccur if aprotinin were used in humen body,even induced todead.Ulinastinin abstract ed from health men's urine , because...
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