Effest Of Ulinastatin On Postoperative Insulin Resistance Of Gastrointestinal Cancer Patients

OBJECTIVETo observe the effect of ulinastatin (UTI) on the postoperative insulin resistance of patients with gastric or colon cancer.METHODS22 patients were randomly divided into control group and experimental group (n=11). For patients of the experimental group, UTI was administrated intravenously with a dosage of 200000U before surgery and q8h postoperatively until 72 hours, the control group was only as a routine trestment. Blood glucose (BG), insulin (INS), C-reactive protein (CRP) were measured in both groups before and 24,72 hours after surgery. Insulin resistance was determined by SSPG and HOMA before and at 24,72 hours after operation. Indicies incluing insulin resistance (HOMA-IR), basic function of pancreatic-β(HOMA-β) and insulin sensitivity index (ISI) were calculated according to the formula. Occurrence of SIRS was determined according to the criteria of ACCP and SCCM.RESULTSSIRS occurred in five patients(5/22,22.7%) during the first 3 days after operation. The SSPG levels of both groups increased significantly on POD1 (F=9.699, P<0.05), and for the experimental group, it decreased on POD3(72h) (P<0.05)while in the control, the SSPG persisted on a high level(P>0.05). The indicies about HOMA were not different to each other significantly (F=1.453,2.413,2.420, P>0.05).for the CRP concentrations, it increased significantly in both groups after surgery and no significant difference was detected.CONCLUSIONSapplication of Uti duiring the periopeative period may inhibit the postoperative insulin resistance singnificanty for patients with gastrointestinal cancer.