乌司他丁对减轻心脏瓣膜置换术后肾缺血再灌注损伤的临床研究

目的探讨体外循环（CPB）心脏瓣膜置换手术后应用乌司他丁对术后肾缺血再灌注损伤的影响。方法将行心脏瓣膜置换手术的80例患者按随机数字法分为2组各40例。实验组予乌司他丁（0．8～1．0）万U／kg置入预充液中随机转入体内，术后第1、2、3天每天给予乌司他丁（0．8—1．0）万U／kg静脉滴注。对照组不用乌司他丁，而给予等量生理盐水。两组均在术前1d，术后第1，3，5，7天测定血清肌酐、血清尿素氮（BUN）、尿微量白蛋白（UAE），血清及尿β2-微球蛋白（β2-MG）。结果2组患者术前肾功能各项指标差异均无统计学意义（P〉0．05）。手术后2组肾功能各项指标均较术前增加。实验组术后第1、3、5天BUN，尿β2-MG，术后第1、3天血清肌酐、血β2-MG，及术后第1天UAE均低于对照组，差异有统计学意义（P〈0．05）。结论乌他司丁对心脏瓣膜置换手术引起的肾缺血再灌注损伤有保护作用。

Ulinastatin protects kidney function after ischemia-reperfusion in patients undergoing prosthetic valve replacement

Objective To investigate the protection function of ulinastatin for kidney after ischemia-reperfusion in patients undergoing prosthetic valve replacement. Methods Eighty patients undergoing prosthetic valve replacement were randomly divided into two groups : UTI group (n = 40) and control group ( n = 40). In UTI group, UTI (8000 ～ 10,000)U/kg body weight was added in the priming solution and UTI (8000 ～ 10,000)U/kg body weight intravenously was applied in the first three days after operation. In control group normal saline was given. Blood and urine samples were taken before operation, on the 1st, 3rd, 5th and 7th day after operation. Serum croatinine (Cr) , urea nitrogen (BUN), urinary atom albumin (UAE), serum and urinary β2-microglobulin (β2-MG) were detected. Results There were no significantly differences among all indexes between two groups before operation(P 0.05). All indexes in two groups increased after operation. In UTI group , serum BUN and urinary β2-MG on 1st, 3rd and 5th , serum Cr and β2-MG on 1st, 3rd, and serum UAE on 1st day were all significantly lower than those in control group( P <0.05 ). Conclusion Ulinastatin provides remarkable protection for kidney after ischemia-reperfusion in patients undergoing prosthetic valve replacement.