活体肾移植供体应用乌司他丁对受体肾功能影响的研究

目的研究乌司他丁应用于活体肾移植供体对受体术后移植肾功能的影响。方法选择行活体肾移植的供体和受体40对，按其供体是否应用乌司他丁分为乌司他丁组和对照组，每组20对。患者均签署知情同意书，符合医学伦理学规定。乌司他丁组供体在麻醉前即以乌司他丁5kU／kg静脉泵入。比较两组受者的一般资料；比较两组受者麻醉前、麻醉后、受体血管开放时和手术结束时的平均动脉压和心率；采用酶联免疫吸附试验（ELISA）法检测两组受者麻醉前、手术结束时和手术结束后24h血浆胱抑素C和α1-微球蛋白（α1-microglobulin，α1-MG）水平。结果两组受体的年龄、性别、体重指数、手术时问、术中输液量、术后24h尿量、冷缺血时间和热缺血时间比较差异无统计学意义（均为P〉0．05）。两组受体的平均动脉压和心率在各个时间点比较差异无统计学意义（均为P〉0．05）。受体手术结束时、手术结束后24h两个时间点的血浆胱抑素C和α1-MG水平较麻醉前时间点明显下降，两组在同时间点比较差异亦无统计学意义（均为P〉0．05）。结论本研究供体所应用乌司他丁的剂量和方法对移植后肾功能的改善效果不显著。

Effect of applying ulinastatin in donors on the renal function of recipients in the living donor renal transplantation

Objective To investigate the effect of applying ulinastatin in donors on the renal function of the recipients in the living donor renal transplantation. Methods Forty pairs of donors and recipients of living donor renal transplantation were assigned to the ulinastatin group and control group according to the use of ulinastatin, 20 pairs of donors and recipients in each group. Local ethical committee approval had been received and the informed consent of all patients was obtained. The donors in the ulinastatin group were given 5 kU/kg ulinastatin by intravenous pump before the anesthesia. The general data of the recipients between the 2 groups, the mean arterial pressure and heart rate were compared at the time of pre-and post-anesthesia, vessels opening and post operation. Blood samples of the recipients were taken before the anesthesia, the end of the operation and 24 h after the operation. The levels of plasma cystatin C and α1 -microglobulin （α1-MG） were detected by enzyme-linked immunoabsorption assay （ELISA）. Results There were no significant differences in the age, gender, body mass index, operation time, intra-operative transfusion volume, the postoperative 24 h urine volume, cold ischemia time and warm ischemia time between 2 groups （ all in P 〉 0. 05）. There were no significant differences in mean arterial pressure and heart rate between 2 groups at every time point （ all in P 〈 0. 05）. The cystatin C and α1-MG levels of the recipients at the end of the operation, and 24 h after the operation decreased evidently compared with those before the anesthesia. But there was no significant difference between 2 groups at the same time point （ all in P 〉 0. 05）. Conclusions The dose and dosage regimen of ulinastatin in this study achieves little effect on the improvement of transplanted kidney function.