Effect of Edaravone Combining Ulinastatin on Brain Protection in Patients of Type A Aortic Dissection After Total Arch Replacement
10.3969/j.issn.1000-3614.2017.03.014
- VernacularTitle:依达拉奉联合乌司他丁对A型主动脉夹层全弓置换术患者的脑保护作用
- Author:
Xianyue WANG
;
Wenpeng DONG
;
Tao YAN
;
Shenghui BI
;
Ben ZHANG
;
Hua LU
;
Xiaowu WANG
;
Weida ZHANG
- Keywords:
Aortic aneurysm;
Aortic arch replacement;
Trypsin inhibitor
- From:
Chinese Circulation Journal
2017;32(3):266-269
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To observe the effect of edaravone combining ulinastatin on brain protection in patients of type A aortic dissection (AAD) after total arch replacement. Methods: A total of 60 AAD patients with total arch replacement in our hospital from 2014-09 to 2016-01 were prospectively studied. Based on peri-operative application of edaravone and ulinastatin, the patients were divided into 2 groups: EU group: 1) the patients received ulinastatin 300000 U/8h and edaravone 0.5mg/Kg/12h from administration to 3 days post-operation, 2) during cardiopulmonary bypass, the patients received ulinastatin 300000 U/2h and edaravone 0.5mg/Kg; Control group, the patients had no such treatment.n=30 in each group. The following items were observed:①operative condition;②blood levels of speciifc brain injury markers as S-100 and neuron speciifc enolase (NSE) at different time points: beginning of surgery (T0), opening aorta clamp (T1), right after cardiopulmonary bypass (T2), entering ICU (T3), 24h post-operation (T4) and 3 days post-operation (T5); ③post-operative condition. Results:①Durations of operation, cardiopulmonary bypass, cardiac arrest and bilateral antegrade selective cerebral perfusion (BACP), the frequency of BACP and UACP (unilateral antegrade selective cerebral perfusion), the lowest rectal temperature and blood levels of S-100, NSE at T0 were similar between 2 groups.②Compared with Control group, EU group had decreased S-100 and NSE from T1 to T5,P<0.05.③The in-hospital and ventilation time, frequency of PND and TND, the patients with CSS score≥16 before discharge and the in-hospital death rate were similar between 2 groups,P>0.05. Conclusion: Edaravone combining ulinastatin had brain protective effect in AAD patients after total arch replacement;it may reduce blood speciifc brain injury markers while the clinical signiifcance should be further investigated.
