乌司他丁在胸外科手术中抗侵袭作用的研究

Ulinastatin suppresses inflammation and protects liver and kidney functions after chest operation

目的:探讨乌司他丁对胸部手术患者术后抗炎性反应和对肝肾功能的保护作用。方法:选取40例胸外科手术的患者,随机分为试验组和对照组,每组各20例。乌司他丁组术前1d和术后1、2、3 d应用乌司他丁30万单位,静脉滴注,10万单位/8 h(1 h内滴完);对照组在相同时间给予等量等渗盐水。分别于手术前1 d和术后1、3、5、7 d抽取外周血标本检测白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)和谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TB)、肌酐(SCr)和尿素氮(BUN)。结果:乌司他丁组患者的IL-6、IL-8、TNF-α等指标在术后1、3、5、7 d均明显低于对照组,乌司他丁组术后第1、3、5 d AST,ALT以及TB比对照组明显低。术后1周内乌司他丁组患者肝肾功能恢复正常。结论:乌司他丁对接受胸外手术患者术后肝、肾功能恢复有保护性作用,通过减少有害细胞因子的产生达到保护机体的作用,提高了机体对手术应激反应的耐受能力。

Objective ：To evaluate the effects of ulinastatin on inflammatory response and liver and kidney functions after chest operation. Methods：Forty patients who received chest operation were randomly divided into two groups as test group （20） and control group （20）. For the test group, we use 300 000 unit ulinastatin respectively 1 day before and 1, 2, 3 days after the operation. For the control group, we use the physiological saline at the same time. We detected IL-6, IL-8, FN and TNF-α levels and functions of several viscera by measuring aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, total bilirubin （TB）, Scr, BUN, Cr pre-operation and 1 d, 3 d, 5 d and 7 d post-operation. Results ： In the operation group, the levels of IL-6, IL-8 and TNF-α were lower than those of patients in the control group at 1 d, 3 d, 5 d, and 7 d after operation. The levels of ALT, AST, and TB of patients in the test group were lower than those of patients in the control group at 1 d, 3 d, and 5 d after opera-tion. The liver and kidney function recovered to normal in the test group 7 d post operation. Conclusion： Ulinastatin has protective effect during the recovery of patient＇s liver and kidney functions after chest surgery. The results confirmed that ulinastatin can enhance the body＇s tolerance to surgery stress by suppressing the secretion of harmful cytokines.