The Lung Protective Effect Of Ulinastatin(UTI) On Pulmonary Artery Perfusion

Objective:To evaluate the effect of perfusion of pulmonary artery using hypothermic protective solution with ulinastatin(UTI) on the inflammatory response of lung during cardiopulmonary bypass(CPB).Methods:30 patients undergoing mitral valve replacement were randomly divided into two groups.The UTI perfusion group(n=15) were perfused 4℃oxygenated blood with UTI 5000U/kg to the pulmonary artery during CPB.The control group(n=15) were perfused 4℃oxygenated blood to the pulmonary artery during CPB.Record the IL-8.IL-10.TNF-a level before CPB,6hour after CPB,12hour after CPB,24hour after CPB.Record Respiratory index(RI=A-aDO2/PaO2) and oxygenate index of alveolus(OI) before CPB,1/2 hour after CPB,6 hour after CPB.Results:At 6hour after CPB the leve of IL-8,TNF-a in control group were higher significantly than the time befor CPB and the UTI group in the same time(P＜0.01),IL-10 in UTI group were higher significantly than the time before CPB and the control group(P＜0.01);At 12hour after CPB the leve of TNF-a in control group were higher significantly than the time befor CPB and the UTI group in the same time(P＜0.01),IL-10 in UTI group were higher significantly than the time before CPB and the control group(P＜0.01),IL-8 there were no difference between two groups(P＞0.05),but all higher than the time before CPB(P＜0.01);At 24 hour after CPB the leve of TNF-a in control group were higher significantly than the time befor CPB and the UTI group in the same time(P＜0.01),IL-10 in UTI group were higher significantly than the time before CPB and the control group(P＜0.01),IL-8 there were no difference between two groups(P＞0.05),but all higher than the time before CPB(P＜0.01);At 1/2 hour after CPB the leve of OI,RI were no difference between two groups,but bigher than the time before CPB,(P＜0.01);6 hour after CPB in control group were higher significantly than the time befor CPB and the UTI group in the same time(P＜0.01),IL-10 in UTI group were higher significantly than the time before CPB and the control group(P＜0.01),IL-8 there were no difference between two groups(P＞0.05),but all higher than the time before CPB(P＜0.01);At 1/2 hour after CPB there were no difference in OI, RI between the two groups.At 6 hour after CPB the UTI group all lower than the control group(P＜0.01).Conclusion:Ulinastatin can adjust the dynamic equilibrium between the prmote inflammation system and anti-inflammation system in restrain inflammatory factor TNF-a,promote anti-inflammatory factorial-10 release.thereby it restrain leukocytal activation,reduce the lung injury after CPB,improve lung function after operation.