摘要
Objective: To study the effect of ulinastatin on the pathological links related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass. Methods: The patients undergoing valve replacement under cardiopulmonary bypass between February 2015 and December 2017 in Mianyang Central Hospital of Sichuan Province were chosen as the research subjects and randomly divided into the experimental group who accepted ulinastatin + creatine phosphate sodium intervention and the control group who accepted creatine phosphate sodium intervention. The levels of myocardial injury markers, apoptosis molecules, inflammation molecules and oxidative stress molecules in serum as well as the expression intensity of inflammation molecules and oxidative stress molecules in peripheral blood were determined before surgery and 24 h after surgery. Results: Serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF-α, ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of both groups of patients after surgery were significantly higher than those before surgery, and serum cTnI, CK-MB, H-FABP, sFasL, sTWEAK, Caspase-3, Caspase-8, IL-1β, TNF- , ICAM1, MDA and NO levels as well as peripheral blood TLR4, NLRP3, NOX2 and iNOS expression intensity of experimental group after surgery were significantly lower than those of control group. Conclusion: Ulinastatin can improve the apoptosis, inflammation and oxidative stress related to myocardial injury and ischemia reperfusion after cardiac surgery under cardiopulmonary bypass.
