乌司他丁对原位肝移植术患者中性粒细胞CD_(11b)/CD_(18)表达的影响

Effect of ulinastatin on the expression of neutrophil CD_(11b)/CD_(18) in patients during orthotopic liver transplantation

目的探讨原位肝移植术中乌司他丁对中性粒细胞表面粘附分子CD_(11b)/CD_(18)表达的影响。方法择期行原位肝移植术患者40例,随机分为2组。乌司他丁组(U组,n=20)：切皮后开始持续静脉输注乌司他丁30万单位(加入100ml生理盐水中),每4小时重复一次；对照组(C组,n= 20)：以等容量生理盐水代替。分别于切皮前即刻、切皮后120min、无肝期30min、新肝期60min和术毕采集外周静脉血1ml,采用流式细胞仪测定中性粒细胞表面粘附分子CD_(11b)和CD_(18)的表达。结果与切皮前比较,U组各时间点CD_(11b)和CD_(18)表达的差异无统计学意义,而C组新肝期60min和术毕时其表达明显上调(P＜0.01)。与C组比较,新肝期60min U组CD_(11b)和CD_(18)表达明显降低(P＜0.01)。结论乌司他丁可抑制原位肝移植术中患者CD_(11b)/CD_(18)表达的上调,有助于减轻炎性反应。

Objective To investigate the effects of ulinastatin on the expression of neutrophil CD11b and CD18 during orthotopic liver transplantation（OLT） .Methods Forty patients with liver diseases, ASA m or IV, undergoing OLT were randomly divided into two groups. Ulinastatin group （ n = 20）received intravenous infusion of ulinastatin 3 × 10^5 IU in 100 ml normal saline after skin incision and repeated every 4 hours thereafter. Control group received same amount of normal saline instead （ n = 20）. Blood samples were taken immediately before skin incision, 120 mln after skin incision, 30 rain of anhepatic phase, 60 min of neohepatic phase and at the end of operation for measurement of CD11b and CD18 expression of neutrophil by flow cytometry. Results CD11b/CD18 expression was increased significantly in control group 60 rain of neohepatic phase and at the end of operation compared to the level before skin incision, but in ulinastatin group there was no significant change in CD11b/CD18 expression during the whole procedures （ P 〉 0.05 ） . CD11b/CD18 expression was significantly lower 60 min of neohepatic phase and at the end of operation in ulinastatin group than in control group （ P 〈 0.01 ）. Conclusion Ulinastatin can inhibit the increase in CD11b/CD18 expression during OLT, and be helpful for reducing the inflammatory response.