Effect of ulinastatin on early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and its clinical value

Abstract

Objective To investigate the roles of ulinastatin in early inflammatory and T lymphocyte immune responses in patients with severe multiple trauma and analyze its clinical value. Methods Forty patients with severe multiple-trauma admitted in our center from January 2016 to January 2019 were enrolled in this study, and randomly divided into ulinastatin group (n=20) and control group (n=20). The patients of the control group were given conventional treatment, and those of the ulinastatin group were given an intravenous infusion of ulinastatin, 100 kU, 3 times per day, from the day of admission for 7 consecutive days besides conventional treatment. The counts of T lymphocyte subsets (CD3+ and CD4+), ratio of CD4+/CD8+, levels of inflammatory factors (TNF-α and IL-6) and cortisol, and other clinical relevant indexes were measured and compared before treatment, on days 1, 3 and 7 after treatment, respectively. Results The counts of CD3+ and CD4+ lymphocytes and the ratio of CD4+/CD8+ were significantly higher in the ulinastatin group than the control group on days 1, 3 and 7 after treatment (P < 0.05), while the serum levels of TNF-α, IL-6 and cortisol were obviously lower (P < 0.05). There were no notable differences in the levels of alpha-alanine aminotransferase (ALT), urea nitrogen (BUN) and creatinine (Scr) between the 2 groups. But significant differences were seen in the average length of hospital stay, length of ICU stay and incidence of complications between them (P < 0.05), though no difference in mortality. Conclusion Ulinastatin can promote the recovery of T lymphocyte subsets, decrease the release of inflammatory cytokines and reduce the inflammatory response in early after severe multiple injuries, and thus can reduce the lengths of ICU stay and hospital stay and incidence of complications, but it has no effect on mortality.

Keywords

• ulinastatin
• trauma and injuries
• tumor necrosis factor-alpha
• interleukin-6
• cortisol
• t-lymphocyte subsets