Effects of ulinastatin on plasma S-100β protein,inflammatory mediators and cognitive function in patients with cardiopulmonary bypass

Objective To observe the effects of ulinastatin on plasma S-100β protein,inflammatory mediators and cognitive function in the patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods Forty patients undergoing elective cardiac valve replacement with CPB were equally randomized into ulinastatin group(group U) and control group(group C).Intravenous ulinastatin 10 000 U/kg before incision and ulinastatin 10 000 U/kg in the priming fluid were administrated in group U,whereas the same volume of saline was administrated in group C.The blood samples taken from internal jugular vein before introduction(T1),at the end of CPB(T2),2 hours(T3),6 hours(T4) and 20 hours(T5) after CPB were analyzed for the concentrations of plasma S-100β protein,interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α).Scores were recorded 1 day before and 3 days,7 days after operation to investigate the incidence of postoperative cognitive dysfunction(POCD).Results The concentrations of plasma S-100β protein,IL-6 and TNF-α at T2-T5 were higher than those at T1(P 0.05).Compared with group C,these indicators were much lower than those in group U(P 0.01).Two patients developed POCD in group U and seven patients in group C(P 0.05).Conclusion Ulinastatin can attenuate the release of inflammatory mediators during cardiac valve replacement with CPB,and decrease the incidence of POCD.