Protective effects of ulinastatin on lung in patient undergoing lung resection after chemotherapy / 中华麻醉学杂志

ABSTRACT

Objective To investigate the protective effects of ulinastatin on the lungs in patients undergoing lung resection after chemotherapy for lung cancer.Methods Thirty ASA Ⅱ or Ⅲ patients with lung cancer(Ⅲ a)aged 54-71yr weighing 55-74 kg undergoing lung resection after chemotherapy were randomly divided into 2 groups(n=15 each)Ⅰ ulinastatin group received ulinastatin 10 000 U?kg~(-1) after induction of anesthesia and Ⅱ control group received normal saline instead of ulinastatin.The patients were premeditated with intramuscular pothidine 70 mg and scopolamine 0.3 mg or atropine 0.5 mg.Anesthesia was induced with midazolam 0.05 mg?kg~(-1),fentanyl 4 ?g?kg~(-1) propofol 0.5-1.0 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 1%-2% isoflurane inhalation and vecuronium infusion at 0.06-0.08 mg?kg~(-1)?h~(-1).Blood samples were taken after induction of anesthesia(T_1,baseline),at 40 and 90 rain of one-lung ventilation(T_2,T_3) for determination of serum IL-6,IL-8,IL-10 and TNF-? concentrations.Lung specimen was taken from the operated lung at 90 min of one-lung ventilation for microscopic examination with light and electron microscopo.Results Serum IL-6,IL-8,IL-10 and TNF-? concentrations were all significantly increased during one-lung ventilation as compared to the baseline values at T_1 in both groups.Serum IL-6,IL-8 and TNF-? concentrations were significantly lower while Serum IL-10 concentration was significantly higher in ulinastatin group than in control group during one-lung ventilation(P＜0.05).The histopathologic changes of lung tissue were significantly less in group utinastatin than in group control.Conclusion Ulinastatin can effectively protect the lung in patients with lung cancer after chemotherapy by reducing systemic inflammatory response.