Scientific Research
Effects of ulinastatin on inflammatory reaction, immunologic function, and postoperative cognitive function of patients undergoing cardiac valve replacement under cardiopulmonary bypass
Cao Xiuli, Xi Gaoyuan, Zhou Junhui
Published 2020-03-01
Cite as IMHGN, 2020,26(05): 620-623. DOI: 10.3760/cma.j.issn.1007-1245.2020.05.007
Abstract
ObjectiveTo investigate the effects of ulinastatin on inflammatory reaction, immunologic function, and postoperative cognitive function of patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).
Methods A total of 100 cases undergoing cardiac valve replacement under CPB were randomly divided into two groups: ulinastatin group (group UTI) and normal saline group (group NS), 50 cases in each group. A continuous dose of ulinastatin (0.5×104 unit/kg) or the same amount of normal saline was injected intravenously in group UTI or group NS before cutting the skin, both of which were completed within 1 h. Central venous blood samples were collected at 30 min before the surgery (T0), 30 min after the beginning of operation (T1), and 1 h (T2), 1 d (T3), 3 d (T4), 5 d (T5) after the end of operation, and the expressions of monocyte-platelet adhesion (CD42a+/CD14+) and monocyte activating capacity (HLADR+/CD14+) were detected by flow cytometry (FCM). Cognitive function tests were performed on the patients of the two groups at 1 d before the surgery and 30 d after the surgery, and the occurrence rate of postoperative cognitive dysfunction (POCD) was calculated by the Z scoring method.
Results The expression of CD42a+/CD14+ in group UTI was obviously lower than that in group NS at T1, T2, T3 (P<0.05), while the expression of HLADR+/CD14+ in group UTI was obviously higher than that in group NS at T3, T4 (P<0.05). As cognitive function tests showed, compared with group NS, the scores of Hopkins Verbal Learning Test (HVLT) and digit span test (FSDT) were both higher in group UTI at 30 d after the surgery (P<0.05). The occurrence rate of POCD was calculated by the Z scoring method: there were 15 cases of POCD in group NS, with the occurrence rate of 30.0%, and 5 cases of POCD in group UTI, with the occurrence rate of 10.0%. Compared with group NS, the occurrence rate was lower in group UTI (P<0.05).
ConclusionUlinastatin can reduce the inflammatory reaction and decrease the occurrence rate of POCD in patients undergoing cardiac valve replacement under CPB.
Key words:
Ulinastatin; Immunologic function; Postoperative cognitive dysfunction (POCD); Cardiac valve replacement
Contributor Information
Cao Xiuli
Department of Surgery, Henan Provincial Chest Hospital, Zhengzhou 450008, China
Xi Gaoyuan
Department of Surgery, Henan Provincial Chest Hospital, Zhengzhou 450008, China
Zhou Junhui
Department of Surgery, Henan Provincial Chest Hospital, Zhengzhou 450008, China