乌司他丁对缺血性脑血管病介入治疗患者血清白细胞介素-1、白细胞介素-6含量及术后认知功能的影响

目的 观察乌司他丁(ulinastatin,UTI)对缺血性脑血管病介入治疗患者血清IL-1、IL-6含量及认知功能的影响,探讨UTI对脑缺血患者的脑保护作用. 方法 选择拟在全身麻醉下行介入治疗的缺血性脑血管病患者50例,年龄40～65岁,ASA分级Ⅰ、Ⅱ、Ⅲ级,BMI 20～28 kg/m2,采用随机数字表法分为两组(每组25例):UTI(U组)和对照组(C组).U组患者麻醉诱导前给予UTI 1万U/kg,术后第1、2、3天延用0.5万U/kg(均由生理盐水稀释至100 ml静脉滴注);C组患者在相同时间段静脉滴注100 ml生理盐水.手术前和术后第1、3天行外周静脉采血,ELISA法检测患者血清IL-1、IL-6含量;同时用简易精神状态检查量表(mini-mental state exam,MMSE)评价两组患者术前和术后第1、3天的认知功能. 结果 U组患者血清IL-1、IL-6含量在术后第1天[(279±140)、(17±6)μg/L]和第3天[(204±83)、(14±4) μg/L]均显著低于C组[第1天(373±142)、(22±8) μg/L;第3天(307±116)、(18±6) μg/L],差异有统计学意义(P＜0.05).U组患者MMSE评分在术后第1天[(28.5±1.0)分]显著高于C组[(27.9±1.2)分],差异有统计学意义(P＜0.05). 结论 UTI可降低缺血性脑血管病介入治疗患者血清IL-1、IL-6含量并改善患者早期术后认知功能.

The effect of ulinastatin on the concentration of interleukin-1 and interleukin-6, and the postoperative cognitive function to patients with ischemic cerebrovascular disease undergone interventional therapy

Objective To observe the effect of ulinastatin (UTI) on the concentration of IL-1 and IL-6,and the postoperative cognitive function to patients with ischemic cerebrovascular disease underwent interventional therapy,and to explore the cerebral protection effects of UTI.Methods Fifty patients with ischemic cerebrovascular disease,40-65 years old,body mass index 20-28 and ASA Ⅰ,Ⅱ,Ⅲ,were randomly divided into group U and group C(n=25) by the random number table method:Group U was given UTI 10 000 U/kg before anesthesia,5 000 U·kg-1·d-1 three days after operation (diluted to 100 ml by normal saline),and group C was given 100 ml of normal saline at the same time.To detect the concentration of IL-1 and IL-6 in serum with enzyme-linked immunosorbent assay and to evaluate the cognitive function with the minimum mental state examination (MMSE) scale on the preoperative day,the 1st and the 3rd postoperative day.Results There was a significant decrease in the concentration of IL-1 and IL-6 in group U on the 1st [IL-1:(279±140) μg/L vs (373±142) μg/L,IL-6:(17±6) μg/L vs (22±8) μg/L],3rd [IL-1:(204±83) μg/L vs (307±116) μg/L,IL-6:(14±4) μg/L vs (18±6) μg/L] postoperative day compared with group C.MMSE scole of group U was higher than that of group C (28.5±1.0 vs 27.9±1.2) on the first day after operation.Conclusions UTI can not only reduce the concentration of IL-1 and IL-6 in serum but also can improve the postoperative cognitive function in patients with ischemic cerebrovascular disease underwent interventional therapy.