Effects of ulinastatin on early postoperative cognitive function after one-lung ventilation surgery in elderly patients receiving neoadjuvant chemotherapy.
We investigated the effects of ulinastatin on early postoperative cognitive dysfunction (POCD) after one-lung ventilation (OLV) surgery in elderly patients receiving neoadjuvant chemotherapy. Eighty elderly patients with preoperative neoadjuvant chemotherapy scheduling for radical esophagectomy under OLV were recruited. They were randomly divided into an ulinastatin pretreatment group (U group, n = 40) and a control group (C group, n = 40). The U group received 10,000 U/kg ulinastatin before anesthesia and 5000 U/kg daily on postoperative days 1 to 3, while C group received saline. Levels of interleukin (IL)-6, IL-10, C-reactive protein (CRP), and S-100β protein were assayed before surgery, at the end of surgery, and on postoperative days 1 and 3. Patients underwent cognitive assessment 1 day before and 7 days after surgery. 38 patients in U group and 37 patients in C group completed the neuropsychological tests. The U group had a lower incidence of POCD than C group (23.7 % versus 45.9 %, P = 0.043). The levels of S-100β protein, IL-6, IL-10, and CRP in both groups increased after surgery. The postoperative concentrations of S-100β protein, IL-6, and CRP in U group were lower than those in C group. On postoperative day 3, compared with C group, the level of CRP in U group was lower, while that of IL-10 was higher. These findings demonstrate that ulinastatin can attenuate the elevation of S100β protein levels and the incidence of POCD, most likely by the mechanism of reducing serum IL-6 and CRP levels and increasing IL-10 levels.
Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, Tiyuanbei, Tianjin, China.|National Clinical Research Center for Cancer, Tianjin, China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Kai-Yuan
KY
Wang
Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, Tiyuanbei, Tianjin, China.|National Clinical Research Center for Cancer, Tianjin, China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
Quan-Yong
QY
Yang
National Clinical Research Center for Cancer, Tianjin, China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.|Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Tiyuanbei, Tianjin, China.
Peng
P
Tang
National Clinical Research Center for Cancer, Tianjin, China.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.|Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Tiyuanbei, Tianjin, China.
Hui-Xia
HX
Li
Department of Anesthesiology, Tianjin Medical University Cancer Institute and Hospital, Tiyuanbei, Tianjin, China. mazuiys@126.com.|National Clinical Research Center for Cancer, Tianjin, China. mazuiys@126.com.|Key Laboratory of Cancer Prevention and Therapy, Tianjin, China. mazuiys@126.com.
Hong-Wei
HW
Zhao
National Clinical Research Center for Cancer, Tianjin, China. renxbtjmu@163.com.|Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tiyuanbei, Tianjin, China. renxbtjmu@163.com.|Key Laboratory of Cancer Immunology and Biotherapy, Tianjin, China. renxbtjmu@163.com.
Xiu-Bao
XB
Ren
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology* / Q000523:psychology; D016207:Cytokines / Q000378:metabolism; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D009483:Neuropsychological Tests; D061810:One-Lung Ventilation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology* / Q000523:psychology; D064568:S100 Calcium Binding Protein beta Subunit / Q000378:metabolism
D016207:Cytokines; D006023:Glycoproteins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D064568:S100 Calcium Binding Protein beta Subunit; C028665:urinastatin
Adjuvant; Chemotherapy; Cognition; One-lung ventilation; Ulinastatin