乌司他丁对缺血性脑血管病介入治疗患者血清白细胞介素-1、白细胞介素-6含量及术后认知功能的影响  

The effect of ulinastatin on the concentration of interleukin-1 and interleuldn-6, and the postoperative cognitive function to patients with ischemic cerebrovascular disease undergone interventional therapy

作　　者：刘中光 刘帆[1] 马玉恒[1] 张树峰[1] 康艳娜 李永旺[1] 

机构地区：[1]中国人民解放军火箭军总医院麻醉科,北京100088

出　　处：《国际麻醉学与复苏杂志》2016年第7期617-620,共4页International Journal of Anesthesiology and Resuscitation

基　　金：北京市自然科学基金（7142169）

摘　　要：目的观察乌司他丁（ulinastatin,UTI）对缺血性脑血管病介入治疗患者血清IL-1、IL-6含量及认知功能的影响，探讨UTI对脑缺血患者的脑保护作用。方法选择拟在全身麻醉下行介入治疗的缺血性脑血管病患者50例，年龄40-65岁，ASA分级Ⅰ、Ⅱ、Ⅲ级，BMI20-28kg／m2，采用随机数字表法分为两组（每组25例）：UTI（U组）和对照组（C组）。U组患者麻醉诱导前给予UTI 1万U／kg，术后第1、2、3天延用0．5万U／kg（均由生理盐水稀释至100ml静脉滴注）；C组患者在相同时间段静脉滴注100ml生理盐水。手术前和术后第1、3天行外周静脉采血，ELISA法检测患者血清IL-1、IL-6含量；同时用简易精神状态检查量表（mini-mental state exam，MMSE）评价两组患者术前和术后第1、3天的认知功能。结果U组患者血清IL-1、IL-6含量在术后第1天[（279±140）、（17±6）μg，L]和第3天[（204±83）、（14±4）μg／L]均显著低于c组[第1天（373±142）、（22±8）p．g／L；第3天（307±116）、（18±6）μg/L]，差异有统计学意义（P〈0．05）。U组患者MMSE评分在术后第1天[（28．5±1．0）分]显著高于c组[（27．9±1．2）分]，差异有统计学意义（P〈0．05）。结论UTI可降低缺血性脑血管病介入治疗患者血清IL-1、IL-6含量并改善患者早期术后认知功能。Objective To observe the effect of ulinastatin （UTI） on the concentration of IL-1 and IL-6, and the postoperative cognitive function to patients with ischemic cerebrovascular disease underwent interventional therapy, and to explore the cerebral protection effects of UTI. Methods Fifty patients with ischemic cerebrovascular disease, 40-65 years old, body mass index 20-28 and ASA Ⅰ, Ⅱ, Ⅲ, were randomly divided into group U and group C（n=25） by the random number table method： Group U was given UTI 10 000 U/kg before anesthesia, 5 000 U.kg-1.d-1 three days after operation （diluted to 100 ml by normal saline）, and group C was given 100 ml of normal saline at the same time. To detect the concentration of IL-1 and IL-6 in serum with enzyme-linked immunosorbent assay and to evaluate the cognitive function with the minimum mental state examination （MMSE） scale on the preoperative day, the 1st and the 3rd postoperative day. Results There was a significant decrease in the concentration of IL-1 and IL-6 in group U on the 1st [IL-1：（279±140）μg/L vs （373±142） μg/L, IL-6：（17±6） μg/L vs （22±8） μg/L], 3rd [IL-1：（204±83） μg/L vs （307±116） μg/L, IL-6：（14±4） μg/L vs （18±6）μg/L] postoperative day compared with group C. MMSE scole Of group U was higher than that of group C （28.5±1.0 vs 27.9±1.2） on the first day after operation. Conclusions UTI can not only reduce the concentration of IL-1 and IL-6 in serum but also can improve the postoperative cognitive function in patients with isehemic eerebrovaseular disease underwent interventional therapy.

关 键 词：乌司他丁 缺血性脑血管病 白细胞介素 术后认知功能障碍 

分 类 号：R743.3[医药卫生—神经病学与精神病学]