| Object:(1) to observe the respiratory function injury caused by cardiopulmonary bypass (CPB) in patients undergoing the coronary artery bypass grafting(CABG),investigate the effect of Ulinastatin on the respiratory function injury, and evaluate the feasibility and necessity of Ulinastatin applied in CPB. (2) to study the effect of CPB on coagulation of patients, and assess the protection effect of Ulinastatin primed in CPB on coagulation function.Methods:40 patients undergoing elective CABG were randomly divided into two groups:Ulinastatin group (Group A) and control group (Group B).Ulinastatin(15Ku/kg) was primed in CPB in group A, while saline in the same dose was primed in group B.2ml arterial blood was extracted to assay the value of PaO2,PaCO2, and Lac, meanwhile the 01 and RI were calculated by formula at five time point:after radial artery puncture (T1), sternal closure (T2),6h after operation (T3),12h (T4) and 24h after operation (T5) Compare the peri-operative parameters including hemodynamic situation, intake and outtake of liquid, extubation time in ICU between two groups.Blood sample was got at T1,T2 to test Hb, Hct and PLT. The value of PT, INR, APTT,TT and Fbg was also measured. At T2, the ACT of blood sample was neutralized below 150.0.4ml blood was extracted to analyse gbACT, CR, PF, TP and MCS by Sonoclot. All the data obtained in this research was continuously analysed by statistical softwares.Results:There were no differences between two groups in terms of demographic and peri-operative hemodynamic variables, as well as the intake and out take of fluids(P >0.05). The value of OI, RI, Lac of all patients was different with that of baseline (P<0.05). At T2,T3,T4 and T5, the value of OI in Group A was statistically higher than that in Group B(P<0.05), however, the value of RI was lower than that in Group B (P<0.05),and at T2,T3, the value of Lac in Group A was lower than that in Group B (P<0.05)At T2, compared with the baseline at T1, the coagulation function parameters including PT,INR,APTT,TT and Sonoclot parameters including gbACT and TP were significantly increased (P<0.05), while the values of Fbg,platelet coun,CR,PF and MCS tend to be decreased (P<0.05). The values of Fbg,CR,PF,and MCS at T2 were statistically higher in Group A than those in Group B (P<0.05), nevertheless, the values of gbACT and TP at T2 were lower in Group A than in Group B (P<0.05). No differences were observed in the rest coagulation function parameters at T2 between two groups (P>0.05)Conclusion:Ulinastatin primed in CPB has a positive effect on lung protection. It can effectively improve the post-operative oxygenation and respiratory function, decrease the lung injury caused by CPB, and promote the rehabilitation of post-operative lung function. It also posses the property of balancing the post-operative lactid-acid metabolism.CPB can significantly interfere the coagulation function in CABG, and the results consist of the decrease of Fbg, the number of platelet and the inhibition of platelet function. Compared with the conventional coagulation function examination, the Sonoclot coagulation and platelet function analysis device has a better sensitivity, a higher accuracy and a quicker report response. This research shows that Ulinastatin applied in CPB can attenuate the damage of coagulation function caused by CPB and thus has the effect of coagulation protection...
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