A Clinical Study On Myocardial Protection Effect Of Ulinastatin In The Patients Who Take The OPCABG Surgery

Objective:To investigate the myocardial protection effects of ulinastatin against myocardial damage in patients who take the off-pump coronary artery bypass graft surgery(OPCAB). And finding out the mechanism of mycocardial protection of ulinastatin preprocessing.Methods:This experiment was double—blinded and controlled.30low risk OPCAB patients were divided into two groups randomly:ulinastatin group(group U,n=15),and control group(group C, n=15).Group U were given10000/kg ulinastatin IU before the coronary arterise reconnected while the group C were given the some dose of sodium chloride at the some time.TnT(troponin T),Hs-TNT (highly sensitive cardiac troponin T),CK-MB(creatine phosphokinase isoenzyme), hs-CRP (high sensitivity C-Reactive Protein), IMA(Ischemic Modified Proteins)were taken form those times:before the operation,4hours,8hours,24hours,48hours after the operation. Heart rate and blood pressure also were been recorded at the following times.Results:No significant difference in the gender,age, ejection fraction, Cardiac output,operation time between the two groups. And the TnT, hs-TnT, CK-MB,,hs-CRP and IMA all had obvious changes after the operation,comparing with the data before the operation. The TnT,hs-TnT in group C and group U all reached a peak in24h after the operation And the group U’s TnT and hs-TNT reduced more than group C in t2-t5(p<0.05). CK-MB got a peak in8h after the operation in both group. hs-CRP value in group U had the highest level in24h while group C had its top in48h.And group U’s CK-MB,hs-CRP average values were lower than group C in t3-t5(p<0.05).IMA levels had got a vertex in4h after the operation in both groups, group U were decreased significantly of IMA than group C in t2-t4(p<0.05).Group U spent less time in Intensive Care Unit contrasted with group C(p<0.05).Conclusions:1. At least, we proved that using ulinastatin in OPCAB had protected myocardial function.heart output function,2. Ulinastatin could restrain the release of C-reactive protein, block the the activated of the inflammatory reaction. it suggest that ulinastatin could reinforce the heart output function by inhibiting the inflammatory response.