title: [Effects of ulinastatin on cognitive function in patients with coronary artery bypass grafting].
abstract: To investigate the effects of ulinastatin(UTI) on postoperative cognitive function in patients undergoing coronary artery bypass grafting.
  
  
  
  One hundred and twenty-seven patients undergoing elective coronary artery bypass surgery were randomly divided into three groups:high-dose UTI group(16000 U/kg i.v.), low-dose UTI group(8000 U/kg i.v.) and control group(normal saline). The levels of plasma cortisol were measured before and one day after surgery. The level of IL-6, IL-10, TNF-α and S100β were measured before operation(T0), at open chest(T1), end of operation(T2), 6 h(T3)and 24 h(T4) after operation. A neuropsychological test scale was to evaluate the cognitive function 1 day before operation, 1 week and 3 months after operation.
  
  
  
  Ninety-three patients completed the study. There was no significant difference in general information of patients among three groups(P>0.05). The level of plasma cortisol one day after operation was significantly higher than that before operation in control group(P<0.01). The levels of plasma cortisol in high-dose UTI group and low-dose UTI group were lower than that of control group(P<0.01). In all groups, the level of plasma IL-6, IL-10, TNF-α and S100B increased remarkably at T2, T3, T4 compared to those at T0(all P<0.05). The level of plasma IL-6, TNF-α(at T2, T3, T4)and S100β(at T3)in high-dose UTI group and low-dose UTI group were all lower than those of control group(P<0.05),while there were no significant differences between high-dose UTI group and low-dose UTI group(P>0.05). The incidence of postoperative cognitive dysfunction in POCD 1 week after operation in high-dose UTI and low-dose UTI groups(25.8% and 23.3%)was lower than that in control group(50.0%), while there were no significant difference 1 month after operation between high-dose UTI group(12.9%) or low-dose UTI group(16.7%)and control group(28.1%). The level of plasma S100β at T2 of POCD patients(n=31)was higher than that of non-POCD group(n=62)(P<0.05).
  
  
  
  Ulinastatin can reduce the incidence of postoperative cognitive dusfunction 1 week after coronary artery bypass surgery, which might be associated with inhibition of inflammation and S100β expression.
authors.affiliation: Department of Anesthesiology, Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China.
authors.forename: Ya-li
authors.initials: YL
authors.lastname: Ge
authors.affiliation: Department of Anesthesiology, Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China.
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Shi
authors.affiliation: Department of Anesthesiology, Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China.
authors.forename: Wen-fei
authors.initials: WF
authors.lastname: Zhu
authors.affiliation: Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210008, China.
authors.forename: Zheng-Liang
authors.initials: ZL
authors.lastname: Ma
authors.affiliation: Department of Anesthesiology, Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China.
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Wei
authors.affiliation: Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210008, China.
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Gu
authors.affiliation: Department of Anesthesiology, Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing 210006, China.
authors.forename: Hong-guang
authors.initials: HG
authors.lastname: Bao
mesh_terms: D003071:Cognition / Q000187:drug effects*; D001026:Coronary Artery Bypass; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D011183:Postoperative Complications / Q000517:prevention & control; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D006023:Glycoproteins; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D064568:S100 Calcium Binding Protein beta Subunit; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; C028665:urinastatin