Effects of Ulinastatin on Vascular Endothelial Cells During Cardiopulmonary Bypass in Patients Undergoing Open Heart Surgery

OBJECTIVE To investigate the effects of ulinastatin on vascular endothelial cells in patients undergoing open heart surgery with cardiopulmonary bypass(CPB). METHODS Twenty-one patients with cardiac function class I～II schedualed for congenital heart disease were randomly divided into three groups:control group(group A,n=7); aprotinin group(group B,n=7)),2500000 unit aprotinin were given intravenously before CPB and same amount of aprotinin added into the priming solution;ulinastatin group (group c,n=7),total of 20000 unit/kg ulinastatin were given intravenously before CPB,the priming solution and during rewarm.Blood samples were taken before CPB(T1),30min following CPB(T2),immediately after discontinuing bypass(T3),3h after the termination of CPB (T4),24h(T5) and 72h(T6) respectively,for determination of von Willebrand Factor(vWF) and endothelin-1(ET-1).RESULTS The level of vWF significantly elevated during CPB and after CPB in all groups. The levels of vWF were lower at T2 and T3 in group B and group C( P 0.01 or P 0.05).The plasma level of ET-1 increased significantly during and after CPB in group A( P 0.01),reached to its top to 3h after discontinuing bypass,and did not return to nomal 72h after the termination of CPB ( P 0.05). While in group B and group C the concentration of plasma ET-1 did not varied significantly. CONCLUSION There were severe endothelial cell damage during CPB,the damage can continued over 72h after the termination of CPB. Ulinastatin is effective in reducing CPB-induced endothelial cell damage.