| Aim:By researching the dynamic variation of related inflammatory factors such as IL-8 and NE and the pulmonary function indicators such as oxygenation index after surgery, analyze the injury mechanism of practicing the cardiopulmonary bypass on children with complex congenital heart disease.We also studied the dose effect of Ulinastatin on the IL-8 and NE and the protective effect on the body after children's complex congenital heart disease surgery.Method:1.30patients at the children's cardiac surgery department in the Second Xiangya Hospital of Central South University were selected and randomly divided into three groups.Experimental group 1(U1)has 10 patients put on a small dose of Ulinastatin. Experimental group 2(U2) has 10 patients put on a large dose of Ulinastatin. Control group (Placebo)C has 10 patients put on placebo.2.Ulinastatin was not used on every patient in three groups during the surgery. Right after the surgery, Ul was given with Ulinastatin 1 x 104U/Kg in 3-5ML normal saline iv every 4 hours,U2 was given with Ulinastatin 2 x 104U/Kg in 3-5ML normal saline iv every 4 hours.Control group was given with the same dose of normal saline without Ulinastatin iv.All these procedures last for 48 hours.3.At Oh(T1),12h(T2),24h(T3),48h(T4)after surgery, all patients' peripheral blood were collected under sterile conditions.The collected peripheral blood was let stand for 10-15min. Then the serum was collected by centrifugation with 3000r,10 minutes, and was tag-packed in the cryopreservation at-80℃.Use the ELISA method to detect the concentration of IL-8 and PMNE.Monitor the oxygenation index and other lung function indices at Oh after surgery (T1'),6h (T2'),12h (T3'),and 24h (T4')Results:1.IL-8 in every group was higher than the normal value at T1 and appeared to be a burst trend. The concentration of IL-8 in three groups was basically the same. And there was no statistical significance (P>0.05). Afterwards it started to increase, and then declined after reaching its peaking level and maintained at a high level at around T2.At this time, IL-8 in U1 and U2 were lower than that in Group C,which had a statistic meaning (P<0.05). Afterwards IL-8 kept decreasing. At T3 and T4, IL-8 in U1 and U2 were lower than that in Group C,which had a statistical significance (P<0.05),-IL-8 in U2 is lower than that in U1,with a statistical significance (P<0.05).2.NE reached its peak value at T1,with no significant difference in every group (P>0.05).Afterwards it started to decline.More declines were seen in U1 and U2 compared to Group C and the decline in U2 was more obvious than that in U1.At T2,IL-8 in U1 and U2 were lower than that in Group C,which had a statistical significance (P<0.05).There was no obvious difference of IL8 in U1 and U2,(P>0.05).At T3 and T4, there was a statistical significance (P<0.05)that IL-8 in U1 and U2 were lower than that in Group C, meanwhile IL-8 in U2 was the lowest (P<0.05).3.At T1',there was no significant difference of the oxygenation index (01) in every group (P>0.05).At T2'and T3',OI in U1 and U2 improved, which had a statistical significance (P<0.05);At T3',OI in U2 improved comparing to that in U1,which had a statistical meaning. (P<0.05)Conclusion:1.The cardiopulmonary bypass surgery performed on children with complex congenital heart disease may cause IL-8 and NE to be released and to burst. 2.Ulinastatin can effectively inhibit the release of inflammatory factors IL-8 and NE as well as inhibit the SIRS after the children's complex congenital heart disease surgery. And there is a dose-effect relationship.3.Ulinastatin can improve the pulmonary ventilatory function after the children's complex congenital heart disease surgery. And there is a dose-effect relationship.
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