乌司他丁对小儿体外循环手术中炎性反应和肾功能的影响

【目的】研究乌司他丁对小儿体外循环（CPB）手术中炎性反应和肾功能的影响。【方法】56例诊断为室间隔缺损的小儿患者随机分为实验组（n=28）和对照组（n=28）。实验组用乌司他丁按1．2万U／kg计算用药量，一次性加入预充液中；对照组以等量生理盐水代替。分别于体外循环前（T1）、体外循环结束后1h（T2）、4h（T3），24h（T4）等时点采集血样，检测炎性介质和肾功能的变化。【结果】CPB前炎性介质和肾功能指标，差异均无统计学意义（P〉0．05）；CPB后炎性介质明显升高（P〈0．05）；实验组CPB后各时点IL6均明显低于对照组，T2，T3时点IL-8均明显低于对照组，T3、T4时点TNF-α明显低于对照组（均P〈0．05）。与T1相比，两组T4BUN均明显升高（P〈0．05）；与对照组相比，实验组T4BUN明显降低（P〈0．05）。【结论】乌司他丁能降低术后IL-6、TNF-α、IL-8水平，减轻炎性反应，同时对肾功能有一定保护作用。

Effect of Ulinastatin on Inflammatory Response and Renal Function in Pediatric Cardiopulmonary Bypass Surgery

Objective] To study the clinical effects of ulinastatin on inflammatory response and renal function. Methods]A total of 126 hospitalized cases of pediatric ventricular septal defect were divided at random into control group and experiment group with 28 cases for each. The experiment group received 12 000 u/kg ulinastatin added into Prefill solution. The control group received isovolume saline. Blood samples were taken before CPB（T~ ）, 1 hour after CPB（T2 ） and 4 （T3）, 24 hours （T4） after CPB to check inflammatory response factors（TNF-α, IL-6, IL-8）and renal function（BUN, Cr）. Results]There were no statistical differences in inflammatory response factors（TNF-α, IL 6, IL-8）and renal function index（BUN, Cr）（ P 〉0.05）, but in- flammatory response factors elevated after CPB（ P 〈0.05）. In experiment group, IL-6 in T2, T3 and T4 was significantly lower than that in control group（ P〈0.05）. IL-8 and TNF-α in T2 ,T3 and T3 ,T4 in experiment group were obviously lower than those in control group（ P〈0.05）. Conclusion] Ulinastatin can decrease the level of IL-6, TNF-αand IL-8 after surgery and protect renal function.