Protection of ulinastatin on lung in cardiopulmonary bypass

Objective To study the protection of ulinastatin(UTI) on lung after cardiopulmonary bypass (CPB). Methods 62 ASA Ⅱ-Ⅲ patients undergoing elective heart valve replacement were divided randomly into three groups:group Ⅰ ( n=20, patient received Saline), group Ⅱ (n=21, patient received UTI 10000U/kg) and group Ⅲ ( n=21 .patient received UTI 20000U/kg). Blood samples were taken from pulmonary vein for determination of plasm levels of interleukin-8(IL-8) and interleukin-10(IL-10). Before CPB and 1min,5min,10min after release of aortic cross-clamp and mechanical ventilation,blood samples from radial artery were collected to assay blood gas and the plasm level of elastase before CPB and 10min after CPB respectively. Right pulmonary tissues (1cm×1cm) were collected before shuting thoracic cavity to measure extravascular lung water(EVLW). Results (1)The levels of plasm IL-8 and IL-10 in three groups increased significantly after release of aortic cross-clamp(P 0.01). Compared with group Ⅰ ,IL-8 in group Ⅱ and group Ⅲ decreased but IL-10 increased obviously at each time point after release of aortic cross-clamp. Compared with group Ⅱ , IL-8 in group Ⅲ significantly decreased but IL-10 increased notably(P0.01). (2)Elastase and EVLW in three groups increased significantly after CPB(P0.01). Compared with group Ⅰ, elastase and EVLW in group Ⅱ and group Ⅲ reduced strikingly and PaO2 in Ⅱ and Ⅲ groups increased significantly after CPB(P0.01 -respectively). Compared with group D .elastase in group Ⅲ reduced notablly but PaC2 was higher(P0. 01 respectively). Conclusion Ulinastatin can decrease the expression of IL-8 ,increase the expression of IL-10,reduce plasm levels of elastase and EVLW. Therefore,it can protect lung tissue after CPB.