乌司他丁对老年肾移植围术期细胞因子的影响  

Effects of Ulinastatin on the Levels of Cytokines During Renal Transplantation in Elder

作　　者：孙煦勇[1] 文宁[1] 农江[1] 文海涛[1] 聂峰[1] 赖彦华[1] 董建辉[1] 李壮江[1] 黄莹[1] 赵东海[1] 曲海燕[1] 

机构地区：[1]解放军第303医院器官移植中心,南宁530021

出　　处：《临床泌尿外科杂志》2009年第2期99-101,共3页Journal of Clinical Urology

基　　金：广西壮族自治区科技攻关项目(0719006-2-7);广西自然科技基金(桂科自0728252)

摘　　要：目的:观察乌司他丁对老年肾移植患者围手术期细胞因子释放的影响,探讨其促进移植肾功能早期恢复的机制。方法:选择30例慢性肾炎肾功能衰竭的老年患者(年龄≥60岁),随机分为对照组(C组)和乌司他丁组(U组),每组15例。U组于手术开始后至循环开放前静滴50万IU乌司他丁,术后5 d继续每天静注30万IU两组分别在术前(T_0)、术毕即时(T_1)、术后第1天(T_2)、术后第3天(T_3)、术后第5天(T_4)、术后第7天(T5)等时点测定血清超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)、白介素(IL)6、IL-8及IL-10的浓度。同时术后第1～30天每天查血肌酐,记录肌酐恢复正常所需天数,记录各组发生延迟肾功能恢复和急性排斥反应的例数。结果:乌司他丁治疗组于T_1、T_2、T_3、T_4、T_5的SOD、IL-10值高于对照组(P<0.05),而MDA、TNF-α、IL-6、IL-8值低于对照组(P<0.05)。血肌酐恢复正常水平时间,两组比较差异有统计学意义(P<0.05)。结论:乌司他丁能够减轻移植肾的缺血-再灌注损伤和排斥反应引起的组织损伤,促进移植肾功能早期恢复。Objective：To investigate the effect of ulinastatin on the release of cytokines and the mechanism of ulinastatin improving postoperative kidney function in elderly renal transplant recipients. Methods： 30 old patients （〉60 years）with chronic nephritis and renal failure were randomly divided into two groups of 15 each： control group （C） and ulinastatin group （U）. Group U received intravenous infusion of ulinastatin 5 × 10^5 IU after skin incision and before establishmant of renal circulation, subsequently ulinastatin 3 × 10^5 IU was administered every day up to 5 d after operation. Group C received the same amount of normal saline instead of ulinastatin. Venous blood samples were taken before anesthesia （To）, at the end of surgery （T1）, at 1 d,3 d,5 d and 7 d after operation （T2 ,T3 ,T4 ,T5 ） for determination of plasma SOD, MDA, TNF-α, IL-6, IL-8 and IL-10 concentrations. The serum creatinine level and the time when serum creatinine became normal were measured at 1-14 days after renal transplantation, the cases of delayed resumption of renal function and acute rejection in each group were recorded. Results：Compared with group C, the plasma level of TNF-α,IL-6,IL-8 and MDA in group U lower significantly （P〈0.05） while IL-10 and SOD higher significantly （P〈0.05）. The time needed for the recovery of serum creatinine in group U were shorter significantly than that in group C （P〈0.05）. Conclusions： Ulinastatin can reduce the ischemic of transplanted kidney, reperfusion injury and tissue injury causeing by rejection, and therefore promote early recovery of renal function.

关 键 词：胰蛋白酶抑制剂 肾移植 细胞因子 老年 

分 类 号：R699.2[医药卫生—泌尿科学]