Effects of ulinastatin on inflammatory factors during cardiopulmo nary bypass

Objective To investigate the effects of ulinastatin on tumor necros is factor(TNF-α), endothelin-1(ET-1), throbonxane A 2(TXA 2), maleic dialde hyde (MDA)and superoxide dismutase(SOD) during the operation on heart with cardio pulmonary bypass (CPB).Methods 30 ASA Ⅱ～Ⅲ patients who underwent elective heart surgery w ere divided into two groups randomly,15 patients in ulinastatin group rece ived ulinastatin 20 000 U/kg,15 patients in control group received sam e volume of saline instead of ulinastatin. Arterial blood samples were taken at the beginning of surgery(t 1), 10 min after aortic release(t 2), 10 min(t 3) and 1 h (t 4) after discontinuation of CPB for blood gas analysis, venous blood samp les were taken at the same time for determination of plasma levels of TNF-α, ET-1, TXA 2, MDA and SOD activity.Results There was no significant diff ere nce between two groups in plasma TNF-α, ET-1, TXA 2, MDA level and SOD activit y before CPB in both groups. The plasma level of TNF-α increased at t 2 in both gr oups and was still high at t 4 in control group but not in ulinastatin group. T he plasma level of ET-1 was increased at t 2 and then decreased in both groups. The plasma level of MDA at t 2 and t 3 was higher than that at baseline in both g roup s, and the level of it in ulinastatin group was significantly lower than that in control group, it returned to the baseline at t 4 in ulinastatin group but was s till high in control group. The plasma activity of SOD increased significantly a t t 2 and t 4 in both groups, and the activity in ulinastatin group was higher tha n that in control group(P0.01). The plasma level of TXA 2 in ulin astatin group w as significantly lower than that in control group at t 2 and t 3, and it retur ned to baseline at t 4 in ulinastatin group. Conclusions Ulinastatin c an improve the respiratory function during CPB by inhibiting the production of TNF -α, TXA 2 and enhancing the plasma activity of SOD.