[Effect of ulinastatin on post-operative cognition disorders in elderly patients undergoing hip joint replacement].
OBJECTIVE
To evaluate the effect of ulinastatin on post-operative Cognition disorders in elderly patients undergoing hip joint replacement.


METHODS
Forty ASA I or II elderly patients undergoing selective hip joint replacement, aged > or = 65 years, were randomly divided into 2 groups (n = 40 each): control group and ulinastatin group. Ulinastatin group received iv infusion of ulinastatin (10,000 u/kg) after skin incision, (5,000 U/kg) after operation 1, 2, 3 d respectively, included 21 males and 19 females with an average age of (75.00 +/- 7.81) years old. Control group received the same volume of normal saline instead of ulinastatin, included 20 males and 20 females with an average age of (72.80 +/- 7.25) years old. Neuroeognitive testing was performed on the preoperative day and on the 3th postoperative day and post-operative cognition disorders was defined as 1 SD decline from baseline on neurocognitive assessment. Serum S100beta protein were measured before operation, at the end of surgery, 3, 24 h and 3 d after operation.


RESULTS
The incidence rate of postoperative cognition disorders was 2.5% in ulinastatin group, there were lower than those of patients in the control group (25%) (P < 0.05); In control group, the scales for MMSE before and after operation were (25.2 +/- 2.1), (22.6 +/-2.5) scores and the level of serum S100beta protein at T0-4 were (0.041 +/- 0.012), (0.125 +/- 0.031), (0.178 +/- 0.036), (0.142 +/- 0.038), (0.048 +/- 0.015) microg/L. As well in ulinastatin group, above date were (25.9 +/- 2.4), (24.8 +/- 2.1), (0.040 +/- 0.013), (0.095 +/- 0.021), (0.116 +/- 0.017), (0.087 +/- 0.019) and (0.043 +/- 0.012) respectively. Compared with preoperative, MMSE evaluation scale was decreased on the 3th postoperative day and the S100beta was increased markedly at T1-3 in control group (P < 0.05); Compared with control group, MMSE evaluation scale was increased and the S100beta was decreased markedly at T1-3 in ulinastatin group (P < 0.05 ).


CONCLUSIONS
Intravenous infusion of ulinastatin during operation can prevent the occurrence of POCD in elderly patients.
Kang
Ya-Mei
YM
Department of Anesthesia, Ningbo 6th Hospital, Ningbo 315040, Zhejiang, China.
Ge
Ye-Ying
YY
Cheng
Jian-Qing
JQ
Chen
Yue-Bo
YB
Yuan
Na
N
Zhao
Liu-Jun
LJ
Xu
Rong-Ming
RM
D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D003072:Cognition Disorders / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood; D011183:Postoperative Complications / Q000097:blood / Q000188:drug therapy*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood
D006023:Glycoproteins; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C028665:urinastatin