Effect of edaravone combined with ulinastatin on pulmonary function and serum surfactant protein A (SP-A) level in patients undergoing thoracoscopic surgery

Abstract

Objective To observe the effect of edaravone combined with ulinastatin on pulmonary function and serum level of surfactant protein A (SP-A) in patients undergoing thoracoscopic surgery. Methods Seventy-two patients scheduled for thoracoscopic surgery were divided into four groups: saline group (control group, n=18); edaravone group (n=18); ulinastatin group (n=18); and edaravone plus ulinastatin group (EU group, n=18). Pulmonary function and SP-A level were evaluated at four time points for each patient: before induction (T0), prior to one-lung ventilation (T1), at the end of operation (T2), and 24 h after operation (T3). Blood specimens were obtained at each time point to test oxygenation index (OI), respiratory index (RI), and the number of polymorphonuclear neutrophils (PMN). ELISA was employed to detect serum level of SP-A. Intraoperative hemodynamic changes, postoperative complications, and hospitalization time were recorded. Results There was no significant difference in hemodynamics among the four groups at all four time points. At T2, OI in the EU group, edaravone group, and ulinastatin group significantly increased compared with the control group (P<0.05), and OI in the EU group was significantly higher than that in the edaravone group and ulinastatin group (P<0.05), while RI and the number of PMN showed opposite changes (P<0.05). At T3, SP-A serum level in the EU group was significantly higher than those in the control group, edaravone group, and ulinastatin group (P<0.05), although there was no significant difference among the control group, edaravone group, and ulinastatin group. Conclusion The effect of combination treatment of edaravone and ulinastatin is superior to monotherapy with either of them in patients undergoing thoracoscopic surgery, which might be related to the inhibition of PMN aggregation and up-regulation of serum SP-A level. Key words: Edaravone; Ulinastatin; One-lung ventilation; Polymorphonuclear neutrophils; Surfactant protein A