Protective effects of ulinastatin on intestinal injury during the perioperative period of acute superior mesenteric artery ischemia.

OBJECTIVE This work aims to explore the protective effects of ulinastatin on intestinal injury during the perioperative period of acute superior mesenteric artery ischemia (ASMAI). PATIENTS AND METHODS 28 patients undergoing revascularization were divided into 2 groups, with 14 cases each. The cases in the observation group (OG) were treated with ulinastatin 300,000 U intravenously 30 min before the operation, and continuously treated with 300,000 U every 4 hr thereafter until 24 hr of the operation, while those in the control group (CG) were not given the intervention of ulinastatin. Patients' circular intestinal fatty acid binding protein (I-FABP) levels were measured at the following time points to reflect the intestinal injury: 30 min before the operation, before revascularization, then 1, 12 and 24 hr after the operation. The white blood cell counting (WBC), serum alanine aminotransferase (ALT), serum creatinine (Cr), D-dimer, and serum endotoxin (ET) were also measured simultaneously for the analysis of the significance of their values with the intestinal injury. RESULTS There were no significant differences (p > 0.05) in ischemia duration, length of the affected intestinal segments, WBC, ALT and Cr levels at the above time points between the 2 groups, and all the indicators of the 2 groups, including the mean circular I-FABP levels before the operation and the revascularization, showed no significant difference (p > 0.05). After the blood supply was restored, the I-FABP levels in OG dropped significantly as compared with those in CG. The pattern of circular ET levels appeared the similar manner as the circular I-FABP levels did. CONCLUSIONS Our study showed a protective effects of ulinastatin on intestinal injury during the perioperative period of ASMAI, as revealed by the circular I-FABP levels which mainly happened after the blood supply was restored.