Objective: To investigate the effect of Ulinastatin on the management of early myocardial injury and its mechanisms.
Methods: Thirty-four severe burn patients with TBSA exceeding 50% were admitted into our hospital within 24 hrs after burns, and they were divided into burn group (n=17) and ulinastatin-treated group (n=17, UTI group). All patients received conventional treatment. The patients in UTI group were given 100,000 U ulinastatin intravenously immediately after admission, 3 times a day for a week. The plasma content of troponin I (cTnI) , creatine kinase (CK-MB) and PMN elastase were determined on 2, 4 and 7 postburn days (PBD), and the correlate relationship among these three indices were analyzed.
Results: (1) The plasma content of cTnI and PMN elastase at 2, 4, 7 PBDs were significantly higher than that of normal value (P < 0.01), but they were obviously lower in UTI group than that in burn group. (2) Compared with normal value, the plasma content of CK-MB in burn group was increased significantly on 2, 4 and 7 PBDs (P < 0.01), and it reached the peak on 4 PBD. Though it was obviously higher in UTS group on 2 and 4 PBDs compared with the normal value, but it was lower than that in burn group ( P < 0.05 or 0.01) , and it returned to normal value on 7 PBD. (3) There exhibited positive correlation among the PMN elastase content, cTnI content and CK-MB activity of the 34 patients. The correlation index of PMN elastase content and cTnI content was 0. 904, while that between cTnI content and CK-MB activity was 0.922, and that between PMN elastase content and CK-MB activity was 0.829 (P < 0.01).
Conclusion: Ulinastatin is beneficial in alleviating myocardial injury after severe burns, and it reduces the release of PMN elastase.