Effects Of Ulinastatin In Adult Congenital Heart Disease Peri Operation Period In Different Stages Of Myocardial Enzyme Spectrum

Objective :To investigate in adult congenital heart disease(ACHD) surgical treatment, around the different stages of surgery, especially heart surgery during cardiopulmonary bypass due to ischemia-reperfusion injury caused by, resulting in varying degrees of myocardial damage, heart dysfunction; and by observing myocardial enzymes: aspartate aminotransferase(AST), creatine kinase(CK), lactate dehydrogenase(LDH),hydroxybutyrate dehydrogenase(HBDH) changes in the perioperative period circumstances, and the impact on the application of myocardial enzymes ulinastatin(UTI)after further clarify UTI in adult congenital heart disease patients undergoing different stages of the protective effect of cardiac surgery and treatment.Methods:45 cases accept adult open heart surgery to patients with heart disease, were randomly divided to treatment group U(U1, U2) and control group(Group C),respectively, in each group of 15 cases.U group according to the treatment of UTI1IU/Kg U1 group(intraoperative and postoperative medication): during operation anesthesia before cardiopulmonary bypass add 1 / 2 of the priming solution in, more than1 / 2 in open, inferior vena cava after adding oxygen and in, after 5 days of intravenous drip UTI; U2 group(full medication), 3 days before the operation, operation(with U1 group were administered) and postoperative intravenous drip UTI 5 days; control group(Group C): do not accept UTI, capacity was given to the equilibrium liquidalternative.The treatment group and the control group respectively in preoperative day 3morning(T1), postoperative / off chest(T2), after operation in the morning of the first day(T3), postoperative day 3 morning(T4) four time periods in blood were measured blood myocardial enzyme spectrum: aspartic acid transfer enzyme(AST), lactate dehydrogenase(LDH), creatine kinase(CK), hydroxybutyric dehydrogenase(HBDH)level.Results:①Preoperative either U1, U2 group, or control group C group, myocardial enzymes AST, LDH, CK, HDBH were within the normal range, no obvious abnormalities, P>0.05, no statistical significance; ② to surgery off the chest(T2), the first day after(T3),after the first three days(T4) treatment group U1, U2 group and the control group,myocardial enzymes AST, LDH, CK, HDBH are different degrees of increase, U1, U2 group, the indexes increased rate comparison in T2, T3, T4 periods respectively with group C, are low(P <0.05); at the same time, U2 group, the indexes at T2, T3, T4 period liter high amplitude lower than the U1 group(P <0.05).Conclusions:Protease inhibitors Ulinastatin as a clinical widely used in adult congenital heart disease perioperative period, especially the acceptance of open heart surgery procedure,ECC systemic inflammatory response caused by myocardial ischemia-reperfusion injury caused by cell damage, the occurrence of complications such as cardiac dysfunction,serum AST, LDH, CK, were significantly increased when HDBH, full medication better than surgery and postoperative medication, preoperative prophylactic use of cardioprotective drugs can be effective improve due to intraoperative myocardial ischemia-reperfusion injury caused by reducing myocardial ischemia, anoxia, thereby reducing postoperative myocardial enzyme monitoring indicators to prevent aggravation of postoperative complications, the prognosis is clear, after promote heart and lungfunction recovery effect is obvious, hospitalization time was significantly shorter than the control group.