title: The effects of urinary trypsin inhibitor on liver function and inflammatory factors in patients undergoing hepatectomy: a prospective, randomized, controlled clinical study.
abstract: BACKGROUND
  The inhibition of inflammation exerts benefits following massive hepatectomy in animals but not in the clinic. The aim of this study was to investigate the effectiveness and mechanism of ulinastatin on liver function and outcomes following hepatectomy.
  
  
  METHODS
  One hundred seventy-six patients undergoing hepatectomy were randomized into the treatment group (n = 86) and the control group (n = 90), receiving ulinastatin 150,000 U twice daily for 3 days and saline vehicle, respectively. Liver function, coagulation, thrombokinase, lymphocyte subsets CD4 and CD8, C-reactive protein, inducible nitric oxide synthase, and cytokines were measured. Clinical outcomes were also evaluated.
  
  
  RESULTS
  Serum alanine transaminase, aspartate transferase, inducible nitric oxide synthase, and tumor necrosis factor-α levels were significantly lower after ulinastatin treatment, and the response of bilirubin was delayed. The benefits of ulinastatin were shown mainly in major hepatectomy earlier after surgery. The treatment significantly reduced hospital length of stay and recovery-related cost.
  
  
  CONCLUSIONS
  Ulinastatin protects liver function and improves clinical outcomes, possibly via the inhibition of inflammation and oxidation at an earlier stage following major hepatectomy.
authors: Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Huayu
authors: H
authors: Yang
authors: Yilei
authors: Y
authors: Mao
authors: Xin
authors: X
authors: Lu
authors: Xinting
authors: X
authors: Sang
authors: Shunda
authors: S
authors: Du
authors: Haitao
authors: H
authors: Zhao
authors: Yiyao
authors: Y
authors: Xu
authors: Haifeng
authors: H
authors: Xu
authors: Zhiying
authors: Z
authors: Yang
authors: Tianyi
authors: T
authors: Chi
authors: Shouxian
authors: S
authors: Zhong
authors: Jiefu
authors: J
authors: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes; D018414:CD8-Positive T-Lymphocytes; D016207:Cytokines / Q000097:blood; D004334:Drug Administration Schedule; D015951:Factor Xa / Q000378:metabolism; D005260:Female; D006023:Glycoproteins / Q000008:administration & dosage / Q000627:therapeutic use*; D006498:Hepatectomy; D017721:Hospital Costs; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000517:prevention & control; D007902:Length of Stay; D008099:Liver / Q000187:drug effects* / Q000378:metabolism*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D052247:Nitric Oxide Synthase Type II / Q000097:blood; D010084:Oxidation-Reduction / Q000187:drug effects; D011446:Prospective Studies; D016896:Treatment Outcome; D014361:Trypsin Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D016207:Cytokines; D006023:Glycoproteins; D014361:Trypsin Inhibitors; D002097:C-Reactive Protein; D052247:Nitric Oxide Synthase Type II; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D015951:Factor Xa; C028665:urinastatin; D001663:Bilirubin