The Change Of Urinary NAG/Cr For Patients With Prosthetic Valve Replacement During Perioperative Period And The Protective Effect Of Ulinastatin On Renal

Objective: To investigate the change of urinary NAG/Cr for patients with prosthetic valve replacement during penoperative period and the protective effect of ulinastatin(UTI) on renal.Method:Fifty-three patients undergoing prosthetic valve replacement were devided into two groups randomlyxontrast group(30) and UTI group(23).In UTI group , each patient was injected UTI 20,000 u/kilogram body weight in total intravenously, each 1/3 of which was given after induction ,aorta cross-clamping and rightly after the end of CPB.10 milliliters of urinary sample and 3 milliliters of blood sample was taken from the patient 30 mins before operation(T1),5 mins before aorta cross-clamping(T2),5 mins after reperfusion(T3),at the end of the operation(T4),l,3and 5 postoperative days(T5,T6,T7) repectively . NAG, urinary creatine (Cr), NAG/Cr, urinary protein ,BUNand blood creatine were tested.Patients general conditon,CPB condition and the total dose of furosemide were recorded too. Results:By contrasted to preoperation,NAG/Cr increased at the begining of CPB and reach to top right after reperfusion continuing to the end of the operation and begin to decrease 1 day after operation,but still higher than preoperation 5 days later. Difference of NAG/Cr between groups aresignificant at T3,T4,T5,but not in other time points.The value of NAG/Cr hassignificant relationship with the duriation of CPB ,clamping time of aorta andTM-50,but not with other facters.Conclusion: NAG/Cr increased significantly during perioperative period andthe value of the NAG/Cr is correlated with the CPB time ,clamping time ofaorta and TM-50,and NAG/Cr is a good index in the dignosis of renaldamage;There is some protective effect of UTI on renal.