Effects Of Ulinastatin On IL-10 And TNF-α After Complex Congenital Heart Disease Operation

Objective:To study ulinastatin's protective effects and it's dosages-depended relationship during operative treatment for complex congenital heart disease with long turn CPB.Methods:We confirmed patients as experiment objects who with complex congenital heart disease, younger than 14years old and without any other serious illness, and accepted operation treatment in No.2 Xiang Ya hospital during March,2010 and May,2010. Divide them into three groups in random. We treat group U2 with UTI 20,000U/Kg, U1 with UTI 10,000U/Kg and equivalent NS for C group. The blood sample will be extracted two hours after operation(T1), twelve hours after operation(T2), twenty-four hours after operation(T3) and forty-eight hours after operation(T4), then we tested the concentration of IL-10 and TNF-αin serum by ELISA method and draw the fluctuation trend of them so that we can grasp the inflammatory response level in their internal environment. We also record the basic vital signs, Oxygenation index, mechanical ventilation time and cardiac function before and after operation to understand our patients'condition diversification and relationship which may be related to inflammatory response.Results:The IL-10 concentration in serum is obviously increased and take a statistics significant compare U groups(both U1 and U2) to C group(P<0.05), the TNF-αconcentration also take a meaningful decrease in statistics at the same time (P<0.05). This statistics significant also happened between U1 and U2. Though the cardiac function examination after operation, drainage capacity during 24h after operation and average time that patients stay in Intensive Care Unit(I.C.U.) and mechanical ventilation in U groups didn't appear an apparent difference with C group, but the vary of oxygenation index after operation prompt that a significant difference is existed between U group and C group, this Phenomenon also can be found between U1 group and U2 group.Conclusion:From the statistics analyze results and clinic observation we can conclude that ulinastatin has a manifest effect for complex congenital heart disease patients after operation in reduce TNF-αand increase IL-10, mitigate the inflammatory response. The dose-dependent relationship also be observed. Compare to U1, U2 has a better effects in reduce TNF-αand increase IL-10.