Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2026
Ulinastatin Protects Cognition in Cardiac Surgical Patients.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Hu Yan, Zhou Yile, Ju Huihui, Lu Xianfu, Shi Yi, Fang Hao
Аннотация
PURPOSE: This study aimed to investigate the incidence of postoperative cognitive dysfunction (POCD) in patients undergoing cardiac valve surgery and the potential protective effects of ulinastatin on POCD.
METHODS: This was a prospective, multicenter, randomized, double-blind clinical trial. A total of 300 patients undergoing cardiac valve surgery were enrolled across the 3 hospitals and randomized to the control or ulinastatin treatment groups. The patients' cognition was evaluated using the Mini-Mental State Examination (MMSE). POCD was defined as a lower cognitive score after surgery than the baseline score. Serum levels of proinflammatory cytokines were measured by an enzyme-linked immunosorbent assay.
RESULTS: The incidence of POCD in the control group was significantly higher than those in the ulinastatin group (42/150 vs. 24/150, p <0.05). The MMSE score in the control group was significantly lower after the operation [D0 vs. D3: 27.72 (1.88) vs. 27.09 (2.61), p <0.05], but did not change in the ulinastatin group [D0 vs. D3: 27.63 (2.29) vs. 27.31 (2.47), p >0.05]. In the ulinastatin group, plasma levels of matrix metallopeptidase 9 (MMP9) and S100 calcium-binding protein B (S100β) were significantly lower than those in the control group after the operation.
CONCLUSIONS: The present study confirms that a transient proinflammatory state impairs cognition in patients undergoing cardiac surgery and indicates that perioperative administration of ulinastatin protects cognition.
METHODS: This was a prospective, multicenter, randomized, double-blind clinical trial. A total of 300 patients undergoing cardiac valve surgery were enrolled across the 3 hospitals and randomized to the control or ulinastatin treatment groups. The patients' cognition was evaluated using the Mini-Mental State Examination (MMSE). POCD was defined as a lower cognitive score after surgery than the baseline score. Serum levels of proinflammatory cytokines were measured by an enzyme-linked immunosorbent assay.
RESULTS: The incidence of POCD in the control group was significantly higher than those in the ulinastatin group (42/150 vs. 24/150, p <0.05). The MMSE score in the control group was significantly lower after the operation [D0 vs. D3: 27.72 (1.88) vs. 27.09 (2.61), p <0.05], but did not change in the ulinastatin group [D0 vs. D3: 27.63 (2.29) vs. 27.31 (2.47), p >0.05]. In the ulinastatin group, plasma levels of matrix metallopeptidase 9 (MMP9) and S100 calcium-binding protein B (S100β) were significantly lower than those in the control group after the operation.
CONCLUSIONS: The present study confirms that a transient proinflammatory state impairs cognition in patients undergoing cardiac surgery and indicates that perioperative administration of ulinastatin protects cognition.
Предметные рубрики MeSH
HumansGlycoproteinsFemaleMaleProspective StudiesDouble-Blind MethodCardiac Surgical ProceduresCognitionTreatment OutcomeAgedPostoperative Cognitive ComplicationsMiddle AgedBiomarkersTime FactorsRisk FactorsIncidenceInflammation MediatorsCytokinesMatrix Metalloproteinase 9JapanProtective FactorsS100 Calcium Binding Protein beta Subunit