摘要:Objective It is to observe the influence of different dose of ulinastatin on liver and kidney function and cyto-kine in laparoscopic surgery for patients with gastric cancer.Methods 84 cases patients with laparoscopic surgery for gastric cancer were divided into four groups, before the induction of anesthesia, the patients were treated with 100mL physiological sa-line intravenous drip in the group A, and with Ulinastatin 0.5, 1.0 and 1.5 ×104 IU/kg plus normal saline 100 mL intrave-nous drip in group B, C and D respectively.The liver and kidney function ( ALT, AST, BUN, SCr) and the levels of cytokine ( IL-6, IL-8, TNF-α) were detected at the time points of 1 day before operation and 1, 3, 5 days after operation, respec-tively.Results the contents of ALT, AST, BUN and SCr in the 4 groups were all in normal range before and after operation, there were no significant difference among the four groups at the same time point (all P>0.05).The levels of IL-6, IL-8 at the time points of 1 and 3 days after operation were significantly higher than before operation (all P<0.05), but the in-crease of the group B, C and D were significantly lower than that of the group A (all P<0.05), and those of the group D was significantly lower than those of the group B (all P<0.05).1 day after operation, the levels of TNF-αin the four groups were higher than those before operation (all P<0.05), and there was no significant difference among the 4 groups (all P>0.05);3 days after operation, the content of TNF-αin the group C and D were recovered to the preoperative level, while in the group A and B was still higher than preoperative (all P<0.05);5 days after operation, the level of TNF-αin the group A was still significantly higher than that before operation (P<0.05).Conclusion After laparoscopic gastric cancer surgery, the body will appear IL-6, IL-8, TNF-αirritability increase;ulinastatin can reduce the inflammatory response, and the effect of 1.5 ×104 IU/kg dosage was the best, and there was no obvious damage to liver and kedney function.%目的:研究不同剂量乌司他丁对腹腔镜胃癌手术患者肝肾功能及细胞因子的影响。方法将84例腹腔镜胃癌手术患者随机分为4组:在麻醉诱导前,A组给予生理盐水100 mL静滴,B组、C组、D组分别给予乌司他丁0.5×104 IU/kg、1.0×104 IU/kg、1.5×104 IU/kg加入生理盐水100 mL中静滴。分别于术前1 d及术后1 d、3 d、5 d检测所有患者的肝肾功能( ALT、AST、BUN、SCr)和细胞因子( IL-6、IL-8、TNF-α)水平。结果术前1 d及术后1 d、3 d、5 d,4组患者ALT、AST、BUN、SCr水平均处于正常范围,同一时间点组间比较差异均无统计学意义(P均>0.05)。术后1 d、3 d,4组IL-6、IL-8水平均显著高于术前(P均<0.05),但B组、C组、D组升高的幅度均明显低于A组(P均<0.05),且D组升高的幅度显著低于B组(P均<0.05)。术后1 d,4组TNF-α水平均较术前明显升高(P均<0.05),4组间比较差异无统计学意义(P均>0.05);术后3 d,C组、D组TNF-α水平恢复至术前水平,A组、B组仍显著高于术前(P均<0.05);术后5 d, A组TNF-α水平仍显著高于术前(P<0.05)。结论腹腔镜胃癌手术后机体会出现IL-6、IL-8、TNF-α应激性增高;乌司他丁能够减轻炎性反应,其中以1.5×104 IU/kg的用量效果较佳,对肝肾功能无明显影响。