title: [Effect of ulinastatin on liver function of patients after bilateral total knee arthroplasty].
abstract: OBJECTIVE
  To investigate the effect of ulinastatin, a urinary trypsin inhibitor, on the postoperative liver function in patients who have received bilateral total knee arthroplasty (TKA) under pneumatic tourniquet.
  
  
  METHODS
  Totally 40 patients who were scheduled to receive bilateral TKA under thigh tourniquet were randomly assigned into trial group (U group, receiving intravenous ulinastatin) and control group (C group, receiving natural saline). All patients received the same general anesthesia and postoperative analgesia. The plasma concentrations of alanine transaminase (ALT), total bilirubin (TBil), and direct bilirubin (DBil) were recorded and compared preoperatively and 4, 24, 48, and 72 hours after the surgery.
  
  
  RESULTS
  The demographic data were not significantly different between these two groups (P>0.05). The ALT was not significantly changed after the surgery in the C group (P>0.05) but was significantly decreased 48 hours (P=0.002) and 72 hours (P=0.001) after the surgery in the U group. TBil and DBil were significantly increased 48 hours (P=0.012, P=0.000) and 72 hours (P=0.000, P=0.000) after the surgery in C group, while only that at 48 hours (P=0.010, P=0.038) was significantly increased in the U group. ALT 4 hours (P=0.026), 48 hours (P=0.013), 72 hours (P=0.004) after the surgery were significantly lower in the U group than those in C group. TBil at the 72 hours postoperatively in U group was significantly lower than that in C group (P=0.036). DBil was not significantly different between C group and U group at all time points (all P>0.05).
  
  
  CONCLUSIONS
  The application of ulinastatin in bilateral TKA can protect postoperative liver function.
authors.affiliation: Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Tang
authors.affiliation: Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
authors.forename: Zhong-huang
authors.initials: ZH
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology,People's Hospital of Huaibei,Huaibei,Anhui 235000,China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
authors.forename: Li-ying
authors.initials: LY
authors.lastname: Ren
authors.affiliation: Department of Orthopedic Surgery,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
authors.forename: Wen-wei
authors.initials: WW
authors.lastname: Qian
authors.affiliation: Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
authors.forename: Yu-guang
authors.initials: YG
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D019645:Arthroplasty, Replacement, Knee; D001663:Bilirubin / Q000097:blood; D005260:Female; D006023:Glycoproteins / Q000494:pharmacology*; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D055815:Young Adult
chemical_list: D006023:Glycoproteins; D000410:Alanine Transaminase; C028665:urinastatin; D001663:Bilirubin