[Effect of ulinastatin in traumatic brain injury with multiple injuries].

Abstract

Objective: To investigate the effect of ulinastatin (UTI) in traumatic brain injury (TBI) with multiple injuries.

Methods: A prospective analysis of TBI patients with multiple injuries was performed. Sixty cases of cranial trauma with multiple injuries patients were randomly divided into two groups. There were 28 cases in control group while 32 cases in treatment group. Control group underwent conventional treatment while intravenous infusion of UTI was performed in treatment group. The dose of UTI was 200 kU every 8 hours. Patients' intracranial cerebral pressure (ICP) were monitored at admission and 10 days after treatment. At the same time levels of white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), alanine aminotransferase (ALT), aspartate amino transfer enzymes (AST), creatinine (Cr), blood urea nitrogen (BUN), tumor necrosis factor-α (TNF-α), interleukin (IL-2, IL-6) were detected.

Results: ICP was down trend after treatment in UTI group, but there was no statistical difference compared with the control group. Hepatic and renal function and inflammation factor levels were significantly decreased in both groups. WBC, CRP, PCT, ALT, AST, Cr, BUN, TNF-α, IL-2, IL-6 were significantly lower in UTI group than those in control group (WBC:12.3±4.5×10(9)/L vs. 15.9±6.3×10(9)/L, CRP:46.12±11.47 mg/L vs. 64.24±18.31 mg/L, PCT:4.51±1.27 μg/L vs. 10.51±4.27 μg/L, ALT:47.26±8.23 U/L vs. 60.94±8.39 U/L, AST:42.67±7.63 U/L vs. 68.51±10.17 U/L, Cr:79.62±15.36 μmol/L vs. 102.36±16.82 μmol/L, BUN:6.35±2.36 mmol/L vs. 8.39±1.67 mmol/L, TNF-α:93.6±31.5 μg/L vs. 195.8±23.9 μg/L, IL-2:12.3±4.5 μg/L vs. 15.9±6.3 μg/L, IL-6:52.36±12.46 μg/L vs. 69.34±26.13 μg/L, all P<0.05). The incidence of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) in UTI group were significantly lower than those in control group (21.88% vs. 46.43%, 9.38% vs. 28.57%, both P<0.05).

Conclusion: Application of UTI treatment in TBI with multiple trauma patients can potentially protect the brain, liver and other organ function, thus significantly reduce incidence rate of SIRS and MODS by reducing the release of inflammatory mediators and systemic reaction to the trauma invasion.