PROTECTIVE EFFECT OF DEXMEDETOMIDINE COMBINED WITH
ULINASTATIN ON MYOCARDIUM IN PATIENTS UNDERGOING
VALVE REPLACEMENT
YURU ZHAN 1*, HONGWEI ZHANG 1, ZHENDONG HAN 2
1Department of Anesthesiology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar City 161000, China
2Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar City 161000, China
*corresponding author: zhanyr_3ahqmu@163.com
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Abstract:
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.






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