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Review
. 2016:2016:2571080.
doi: 10.1155/2016/2571080. Epub 2016 Aug 14.

Effect of Ulinastatin in the Treatment of Postperative Cognitive Dysfunction: Review of Current Literature

Zheng-Tao Lv  1 , Jun-Ming Huang  1 , Jin-Ming Zhang  1 , Jia-Ming Zhang  1 , Jin-Feng Guo  1 , An-Min Chen  1
Affiliations
Review

Effect of Ulinastatin in the Treatment of Postperative Cognitive Dysfunction: Review of Current Literature

Zheng-Tao Lv et al. Biomed Res Int. 2016.

Abstract

Background. Ulinastatin, identified as a urinary trypsin inhibitor, has been widely used in patients with inflammatory disorders. However, little is known about its effect on postoperative cognitive dysfunction (POCD). The aim of our current work is to review the current body of literature. Methods. A systematic literature search in PubMed and EMBASE was performed to identify randomized controlled trials. Incidence of POCD, MMSE score, and laboratory indicators (IL-6, TNF-α, CRP, and S100β) were selected as outcomes. Results. Five RCTs involving 461 elderly patients that underwent surgical operations were identified. The meta-analysis suggested no statistical difference of incidence of POCD between ulinastatin and control groups on postoperative day 1; but ulinastatin could significantly decrease the incidence of POCD on postoperative day 3 and day 7 when compared with control treatment. Ulinastatin was effective in improving the MMSE score on day 1, day 3, and day 7 after operation. IL-6 and S100β concentrations were lower up to postoperative day 2. The incidences of postoperative complications in ulinastatin groups were lower than control. Conclusion. Ulinastatin administration was effective in treating early POCD (postoperative day 3 and day 7) and reducing IL-6 and S100β concentrations within two days after operations. Studies with larger-scale and rigorous design are urgently needed.

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Figures

Figure 1
Figure 1
Flowchart of literature search and study selection.
Figure 2
Figure 2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figure 3
Figure 3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figure 4
Figure 4
Forest plot of ulinastatin versus control: incidence of POCD.
Figure 5
Figure 5
Forest plot of ulinastatin versus control: MMSE score.
Figure 6
Figure 6
Funnel plot of ulinastatin versus control: incidence of POCD.
Figure 7
Figure 7
Funnel plot of ulinastatin versus control: MMSE score.
See this image and copyright information in PMC

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