[Protective effects of ulinastatin on the lung injury during cardiopulmonary bypass].
OBJECTIVE
To determine the protective effects and mechanism of ulinastatin on the lung injury during cardiopulmonary bypass (CPB).


METHODS
Thirty patients with rheumatic heart disease (RHD) were divided into 2 groups randomly. The ulinastatin group (Group U, n = 15) received 1 x 10(4)U/kg ulinastatin intravenously before the CPB and the same amount of ulinastatin was added into the primary solution. The control group (Group C,n = 15) received normal saline instead of ulinastatin. A brochioalveolar lavage was performed at 2 h after the cardiopulmonary bypass. Polymorphonuclear neutrophil elastase, tumor necrosis factor-alpha and MDA contents in the brochioalveolar lavage fluids were measured, and the lung oxygenate index was measured preoperatively and at 1 and 4 h after CPB termination.


RESULTS
Polymorphonuclear neutrophil elastase, tumor necrosis factor-alpha and MDA contents of Group U in the brochioalveolar lavage fulids were significantly lower than those of Group C (P < 0.05), and the lung oxygenate index of Group U at 1 and 4 h after CPB termination was also significantly lower than that of Group C. A significant increase of lung oxygenate index occurred in both groups at 1 and 4 h after CPB when compared with the same group at the baseline before CPB (P < 0.05).


CONCLUSIONS
Ulinastatin has the protective effects on the lung injury during CPB by decreasing polymorphonuclear neutrophil elastase, alleviating lung inflammatory reaction and reducing oxygen free radicals.
Wang
Dian-jun
DJ
Department of Cardiothoracic Surgery, Third Xiangya Hospital, Central South University, Changsha 410013 China. wangdianjun5128@yahoo.com.cn
Liu
Jian-xin
JX
Yin
Bang-liang
BL
D000293:Adolescent; D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid; D002315:Cardiopulmonary Bypass; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D020011:Protective Agents / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000517:prevention & control*; D012214:Rheumatic Heart Disease / Q000601:surgery; D014361:Trypsin Inhibitors / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D006023:Glycoproteins; D020011:Protective Agents; D014361:Trypsin Inhibitors; D014409:Tumor Necrosis Factor-alpha; D019272:Leukocyte Elastase; C028665:urinastatin