Effects of ulinastatin on cognitive function in patients with coronary artery bypass grafting
10.3785/j.issn.1008-9292.2015.09.10
- VernacularTitle:乌司他丁对冠状动脉搭桥术后患者认知功能障碍的影响
- Author:
Ya-Li GE
1
;
Hong-Wei SHI
;
Wen-Fei ZHU
;
Zheng-Liang MA
;
Hai-Yan WEI
;
Xiao-Ping GU
;
Hong-Guang BAO
Author Information
1. 南京医科大学附属南京医院麻醉科
- Keywords:
Coronary artery bypass/adverse effects;
Nervous system diseases /etiology;
Interleukin/blood;
Glycoproteins/therapeutic use;
Tumor necrosis factor-alpha/blood;
Cognition disorders
- From:
Journal of Zhejiang University. Medical sciences
2015;(5):532-538
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effects of ulinastatin ( UTI ) on postoperative cognitive function in patients undergoing coronary artery bypass grafting . Methods:One hundred and twenty-seven patients undergoing elective coronary artery bypass surgery were randomly divided into three groups:high-dose UTI group ( 16 000 U/kg i.v.), low-dose UTI group ( 8000 U/kg i.v.) and control group ( normal saline ) .The levels of plasma cortisol were measured before and one day after surgery. The level of IL-6, IL-10, TNF-αand S100βwere measured before operation (T0), at open chest ( T1 ) , end of operation ( T2 ) , 6 h ( T3 ) and 24 h ( T4 ) after operation .A neuropsychological test scale was to evaluate the cognitive function 1 day before operation, 1 week and 3 months after operation. Results: Ninety-three patients completed the study .There was no significant difference in general information of patients among three groups ( P >0 .05 ) .The level of plasma cortisol one day after operation was significantly higher than that before operation in control group ( P <0 .01 ) .The levels of plasma cortisol in high-dose UTI group and low-dose UTI group were lower than that of control group (P<0.01).In all groups, the level of plasma IL-6, IL-10, TNF-αand S100B increased remarkably at T2, T3, T4 compared to those at T0 (all P<0.05).The level of plasma IL-6, TNF-α(at T2, T3, T4)and S100β(at T3) in high-dose UTI group and low-dose UTI group were all lower than those of control group(P<0.05),while there were no significant differences between high-dose UTI group and low-dose UTI group ( P >0 .05 ) .The incidence of postoperative cognitive dysfunction in POCD 1 week after operation in high-dose UTI and low-dose UTI groups (25.8%and 23.3%)was lower than that in control group (50.0%), while there were no significant difference 1 month after operation between high-dose UTI group (12.9%) or low-dose UTI group(16.7%) and control group (28.1%).The level of plasma S100βat T2 of POCD patients ( n=31 ) was higher than that of non-POCD group (n=62) (P<0.05). Conclusion: Ulinastatin can reduce the incidence of postoperative cognitive dusfunction 1 week after coronary artery bypass surgery , which might be associated with inhibition of inflammation and S 100βexpression .
