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PROTECTIVE EFFECT OF DEXMEDETOMIDINE COMBINED WITH ULINASTATIN ON MYOCARDIUM IN PATIENTS UNDERGOING VALVE REPLACEMENT

YURU ZHAN ^1*, HONGWEI ZHANG ¹, ZHENDONG HAN ²

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The aim of the study was to evaluate the myocardial protective effect of dexmedetomidine (Dex) combined with ulinastatin in patients undergoing heart valve replacement (HVR). Thirty-six patients undergoing cardiopulmonary bypass (CPB) were randomly divided into control group (group C), Dex group (group D), ulinastatin group (group U), and Dex combined with ulinastatin group (group B), 9 patients per group. Hemodynamic changes were monitored in all patients. From each patient 3 mL of blood was collected from the internal jugular vein at 30 minutes after anaesthesia induction, 30 minutes after rewarming, 30 minutes, 4 hours and 24 hours after stopping anaesthesia. The concentrations of tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), plasma S100β protein and malondialdehyde (MDA) were measured. The results showed that there was no significant difference in regional arterial blood pressure, central venous blood pressure, heart rate and oxygen saturation between the four groups (p > 0.05). The concentrations of TNF-α, IL-6, MDA and S100β in blood had no significant difference immediately after anaesthesia induction (p> 0.05); 30 minutes after anaesthesia induction, 30 minutes after rewarming, 30 minutes, 4 hours and 24 hours after stopping anaesthesia, the concentration of TNF-α, IL-6, MDA and S100β in group D and U were significantly lower than those in group C, while those in group B were significantly lower than those in groups D and U (p < 0.05). In conclusion, Dex combined with ulinastatin can alleviate myocardial injury in patients undergoing cardiopulmonary bypass valve replacement, and has good myocardial protection, superior to the dexmedetomidine or ulinastatin alone.