Effect of early intervention with ulinastatin on inflammatory cytokines in patients with Stanford A acute aortic dissection during perioperative period
Liu Wei
Lin Peirong
Jin Mu
Cheng Weiping
Sun Lizhong
Abstract：Objective To evaluate the effect of early intervention with ulinastatin on inflammatory cytokines in patients with Stanford A acute aortic dissection during perioperative period.Methods Totally 88 patients with Stanford A acute aortic dissection from May 2013 to May 2015 in Beijing Anzhen Hospital,Capital Medical University were divided into control group (50 cases) and observation group (38 cases) according to admission orders.The control group had routine treatment before operation.The observation group had intravenous infusion with 1 000 000 IU ulinastatin in 250 ml 0.9％ sodium chloride solution 6-8 h before operation.Plasma inflammatory factors including tumor necrosis factor α(TNF-α),serum interleukin 6 (IL-6) and IL-10 were detected after anesthesia induction (T1),at the end of operation (T2),6 h (T3) and 24 h (T4) after operation.Duration of mechanical ventilation,length of intensive care unit(ICU) stay,length of hospital stay,postoperative respiratory complications and mortality were analyzed.Results The level of TNF-α at T2 was significantly higher than that at T1 in both groups [control group:76(12,323) μg/L vs 60(13,206) μg/L;observation group:57(18,87) μg/L vs 52(12,96) μg/L];levels of TNF-α at T3,T4 [control group:54 (15,245)μg/L,59 (16,219)μg/L;observation group:40 (15,87) μg/L,34(12,73)μg/L] were significantly lower than the level of TNF-α at T2 (all P ＜ 0.05).The level of TNF-α in control group at T4 was significantly higher than that at T3;the level of TNF-αα in observation group at T4 was significantly lower than that at T3 (both P ＜ 0.05).The level of IL-6 in control group at T2 was significantly higher than that at T1 [57(13,106) μg/L vs 52(16,108) μg/L];levels of IL-6 at T3,T4 [48(23,94) μg/L,48 (10,91) μg/L] were significantly lower than the level of IL-6 at T2 (all P ＜ 0.05).Levels of IL-6 in observation group at T2,T3,T4 were significantly lower than the level of IL-6 at T1 [53(17,125),48(26,64),45(8,67) μg/L vs 79(38,128) μg/L];levels of IL-6 at T3,T4 were significantly lower than the level of IL-6 at T2;the level of IL-6 at T4 was significantly lower than that at T3 (all P ＜ 0.05).Levels of TNF-α at T3,T4 in observation group were significantly lower than those in control group;the level of IL-6 at T1 in observation group was significantly higher than that in control group;the level of IL-10 at T1 in observation group was significantly lower than that in control group[60(9,169)μg/L vs 96(7,279)μg/L];levels of IL-10 at T3,T4 in observation group were significantly higher than those in control group[83(39,119) μg/L vs 60(6,308) μg/L;90(29,239) μg/L vs 55(6,238) μg/L] (all P ＜0.05).T4/T1 was significantly higher than T2/T1 on IL-10 after statistics in observation group[1.49(0.31,2.26) vs 1.14 (0.45,2.29)] and decreased in control group [0.95 (0.58,1.46),0.51 (0.32,1.07),0.42 (0.24,0.78)] (P ＜ 0.05).Lengths of ICU stay and hospital stay in observation group were significantly shorter than those in control group[65(16,480)h vs 78(8,486)h,14(9,25)d vs 18(14,21)d] (P ＜0.05).Conclusions Early intervention with high dose of ulinastatin can inhibit inflammatory reaction after operation for Stanford A acute aortic dissection,shorten the length of ICU and hospital stay.
Keywords：Dissection of aortaCytokinesUlinastatin
Publication Date：2017-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 521-525 )