Department of Critical Care Medicine, Department of Cardiovascular Surgery; Affiliated People's Hospital, Nanjing Medical University, Wuxi, China.
Eur Rev Med Pharmacol Sci. 2017 May;21(9):2220-2225.
This research is to study the effect of urinary trypsin inhibitor (UTI) on inflammatory cytokines and organ function in patients with cardiopulmonary bypass.
From February 2015 to February 2016, 40 patients that had undergone cardiopulmonary bypass surgery in our hospital were selected and randomly divided into the observation group and the control group with 20 patients in each group. Patients in the control group were intravenously injected with 5000 U/kg normal saline during the operation and 5000 U/kg•d-1 at 1-3 days postoperatively, while the patients in the observation group received intravenous injection of the same amount of UTI at pre-operation (T0), post-anesthesia (T1), after aortic opening (T2), after cardiopulmonary bypass 4h (T3), 8h (T4), 24h (T5), 48h (T6), and 72h (T7). We detected tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-8 (IL-8) levels in each group, and compared the pre and post-operative alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), direct bilirubin (DB) and creatinine level in the two groups of patients.
At the time T3, T4, T5, T6, and T7, TNF-α, IL-1β, IL-6, and IL-8 water in the observation group were significantly lower than those in the control group; the difference was statistically significant (p < 0.05). The 24 h postoperative ALT, AST, and TB of two groups were significantly higher than those pre-operatives (p < 0.05). The ALT and AST levels in the observation group were significantly lower than those in the control group after 24 h postoperative (p < 0.05). The 24 h postoperative TB DB of the two groups had not statistically significant differences (p > 0.05). At 24 h postoperative creatinine levels in the two groups were significantly lower than those before operation (p < 0.05), and there was no significant difference between the two groups (p > 0.05). In the observation group, the duration of ventilation and ICU hospitalization time were significantly lower than that in the control group, and the difference was statistically significant (p < 0.05).
UTI can effectively regulate the inflammatory cytokines and provide protection for organ function during cardiopulmonary bypass surgery, which is conducive to promote the recovery of patients.
本研究旨在探讨尿胰蛋白酶抑制剂（UTI）对体外循环患者炎症细胞因子和器官功能的影响。
选取 2015 年 2 月至 2016 年 2 月我院行体外循环手术的患者 40 例，采用随机数字表法分为观察组和对照组，每组 20 例。对照组患者术中静脉注射 5000 U/kg 生理盐水，术后 1-3 天内 5000 U/kg•d-1，观察组患者术前（T0）、麻醉后（T1）、主动脉开放后（T2）、体外循环后 4h（T3）、8h（T4）、24h（T5）、48h（T6）、72h（T7）静脉注射相同剂量的 UTI。检测各组肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）水平，并比较两组患者术后丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、总胆红素（TB）、直接胆红素（DB）和血肌酐水平。
T3、T4、T5、T6、T7 时观察组 TNF-α、IL-1β、IL-6、IL-8 水平明显低于对照组，差异有统计学意义（p<0.05）。两组患者术后 24 h ALT、AST、TB 均明显高于术前（p<0.05）。观察组术后 24 h ALT、AST 水平明显低于对照组（p<0.05）。两组术后 24 h TB DB 差异无统计学意义（p>0.05）。两组术后 24 h 血肌酐水平明显低于术前（p<0.05），两组间差异无统计学意义（p>0.05）。观察组患者通气时间和 ICU 住院时间明显短于对照组，差异有统计学意义（p<0.05）。
UTI 可有效调节体外循环患者的炎症细胞因子，对器官功能起保护作用，有利于患者的恢复。
