Effects of Different Doses of Ulinastatinon Postoperative Cognitive Function and HMGB1 in Elderly Patients

Li-yuan AN; Bing LI; Gang SU

doi:10.12259/j.issn.2095-610X.S20210720

Volume 42 Issue 7

Jul. 2021

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Li-yuan AN, Bing LI, Gang SU. Effects of Different Doses of Ulinastatinon Postoperative Cognitive Function and HMGB1 in Elderly Patients[J]. Journal of Kunming Medical University, 2021, 42(7): 121-125. doi: 10.12259/j.issn.2095-610X.S20210720

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Li-yuan AN, Bing LI, Gang SU. Effects of Different Doses of Ulinastatinon Postoperative Cognitive Function and HMGB1 in Elderly Patients[J]. Journal of Kunming Medical University, 2021, 42(7): 121-125. doi: 10.12259/j.issn.2095-610X.S20210720

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Effects of Different Doses of Ulinastatinon Postoperative Cognitive Function and HMGB1 in Elderly Patients

doi: 10.12259/j.issn.2095-610X.S20210720

Dept. of Anesthsiaology，The First People’s Hospital of Kunming，Yunnan Kunming 650011，China

Received Date: 2021-05-16
Available Online: 2021-07-19
Publish Date: 2021-07-21

Abstract

Abstract

Objective To study the effects of different doses of Ulinastatin on postoperative cognitive function and HMBG1 in elderly patients. Methods From May 2020 to September 2020, 60 elderly patients older than 60 years of age were selected for elective surgery in our hospital, 36 males and 24 females, aged 60-84 years, weight 46-74 kg, ASA classification Ⅰ -Level Ⅲ. According to the random number table method, they were randomly divided into experimental group （group U1, 2, 3） and control group （group C）, 15 cases in each group. The experimental group was intravenously infused with ulinastatin 5,000 U/kg, 10,000 U/kg, 15,000 U/kg before anesthesia induction, and the control group was given the same dose of normal saline intravenously. We recorded the patient’ s age, education, length of stay, postoperative VAS score and other general information, and collected the patient’ s venous blood 5 minutes after entering the room （T1）, 5 minutes before leaving the PACU （T2）, 1 day （T3） and 3 days （T4） after the operation. The double antibody sandwich enzyme-linked immunosorbent assay was used to monitor the concentration of HMGB1 in patients; the simple intelligent state check scale method was used to evaluate patients before operation （T1）, postoperative 1 （T2）, 3 （T3）, 5 （T4）, 7 （T5）Day cognitive function status. Results The concentration of HMGB1 in each group of patients was increased at T2, T3, and T4 as compared to T1 （P < 0.05）, but T4 was slightly lower than T3 （P < 0.05）. At the end of the operation, the HMGB1 in the 15,000 U/kg UTI group did not rise significantly as compared to the blank group （P < 0.05）. On the first day after the operation, the HMGB1 concentration in the 10,000 U/kg and 15,000 U/kg dose groups was obvious lower than the control group （P < 0.05）. There was no statistical difference in the basic MMSE value of patients in each group. The MMSE scores of the different doses of UTI group showed a downward trend at 1 and 3 days after surgery （P < 0.05）, and there was a statistically significant difference between 5 and 7 days after surgery and 1 day after surgery （P < 0.05）. On day 1 and day 3, the MMSE score of the control group was significantly lower than that of the 15,000 U/kg Ulinastatin group （P < 0.05）. Conclusion 15,000 U/kg Ulinastatin can reduce the incidence of POCD in elderly patients undergoing elective laparoscopic surgery under general anesthesia, and its mechanism may be related to the reduction of HMGB1 in circulating blood.
- Post-operative cognitive dysfunction（POCD）,
- Ulinastatin,
- Elderly patients,
- Inflammatory response,
- High mobility group box-1（HMGB1）

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References(19)

References

[1]	Evered L,Scott D A,Silbert B,et al. Postoperative cognitive dysfunction is independent of type of surgery and anesthetic[J]. Anesth Analg,2011,112(5):1179-1185. doi: 10.1213/ANE.0b013e318215217e
[2]	Kapoor I,Prabhakar H,Mahajan C. Postoperative cognitive dysfunction[J]. Indian J Crit Care Med,2019,23(2):162-164.
[3]	Yu M,Huang H,Dong S,et al. High mobility group box-1 mediates hippocampal inflammation and contributes to cognitive deficits in high-fat high-fructose diet-induced obese ras[J]. Brain Behav Immun,2019,82(11):167-177.
[4]	Chavan S S,Huerta P T,Robbiati S,et al. HMGB1 mediates cognitive impairment in sepsis survivors[J]. Mol Med,2012,18(9):930.
[5]	Guo M,Zhu X,Xu H,et al. Ulinastatin attenuates isoflurane-induced cognitive dysfunction in aged rats by inhibiting neuroinflammation and β-amyloid peptide expression in the brain[J]. Neurol Re,2019,41(10):923-929. doi: 10.1080/01616412.2019.1642564
[6]	Feng L,Chong M S,Lim W S,et al. The modified mini-mental state examination test:normative data for Singapore Chinese older adults and its performance in detecting early cognitive impairment[J]. Singapore Med J,2012,53(7):458-462.
[7]	Kristek G,Rado I,Kristek D,et al. Influence of postoperative analgesia on systemic inflamatory response and postoperative cognitive dysfunction after femoral fractures surgery:a randomized controlled trial[J]. Reg Anesth Pain Med,2019,44(1):59-68. doi: 10.1136/rapm-2018-000023
[8]	Borozdina A,Qeva E,Cinicola M,et al. Perioperative cognitive evaluation[J]. Curr Opin Aneasth-esiol,2018,31(6):756-761. doi: 10.1097/ACO.0000000000000658
[9]	国家卫生统计局. 2018年国民经济和社会发展统计公报[EB/OL]. [2019-02-28]. http://www.stats.gov.cn/tjsj/zxfb/201902/t20190228_1651265.html.
[10]	Skvarc D R,Berk M,Byrne L K,et al. Post-operative cognitive dysfunction:An exploration of the inflammatory hypothesis and novel therapies[J]. Neurosci Biobehav Rev,2018,84(1):116-133.
[11]	Riedel B,Browne K,Silbert B. Cerebral protection:inflammation,endothelial dysfunction,and postoperative cognitive dysfunction[J]. Curr Opin Anaesthesiol,2014,27(1):89-97. doi: 10.1097/ACO.0000000000000032
[12]	Wang X,Zhao B,Li X. Dexmedetomidine attenuates isoflurane-induced cognitive impairment through antioxidant,anti-inflammatory and anti-apoptosis in aging rat[J]. Int J Clin Exp Med,2015,8(10):17281-17288.
[13]	Zhu Y Z,Yao R,Zhang Z,et al. Parecoxib prevents early postoperative cognitive dysfunction in elderly patients undergoing total knee arthroplasty:A double-blind,randomized clinical consort study[J]. Medicine(Baltimore),2016,95(28):e4082.
[14]	Subramaniam B,Shankar P,Shaefi S,et al. Effect of intravenous acetaminophen vs placebo combined with propofol or dexmedetomidine on postoperative delirium among older patients following cardic surgery the DEXACET randomized clinical trial[J]. JAMA,2019,321(7):686-696. doi: 10.1001/jama.2019.0234
[15]	Zhang M,Zhang Y H,Fu H Q,et al. Ulinastatin may significantly improve postoperative conitive function of elderly patients undergoing spinal surgery by reducing the translocation of lipopolysaccharide and systemic inflammation[J]. Front Pharmacol,2018,9(9):1007.
[16]	Inoue K,Takano H. Urinary trypsin inhibitor as a therapeutic option for endotoxin-related inflammatory disorders[J]. Expert Opin Investig Drugs,2010,19(4):513-520. doi: 10.1517/13543781003649533
[17]	陈勇,杜晓红,余树春,等. 老年胃肠肿瘤根治术患者全麻术后早期认知功能障碍的危险因素分析[J]. 中国老年学杂志,2016,36(9):2160-2162. doi: 10.3969/j.issn.1005-9202.2016.09.051
[18]	冯清,张丽娜. 高迁移率族蛋白B1与脓毒症认知功能障碍关系的研究进展[J]. 中华重症医学电子杂志(网络版),2019,5(1):51-55. doi: 10.3877/cma.j.issn.2096-1537.2019.01.009
[19]	Terrando N,Yang T,Wang X,et al. Systemic HMGB1 neutralization prevents postoperative neurocognitive dysfunction in aged rats[J]. Front Immunol,2016,24(7):441.

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