中文摘要：

目的：观察乌司他丁对老年患者下肢关节置换术后认知功能障碍的影响。方法：择期行下肢骨折内固定手术的老年患者40例,随机分为2组：乌司他丁组（UTI组,20例）于手术开始时和术后6 h分别给予乌司他丁200,000U,静滴;对照组（CON组,20例）则给予100 mL生理盐水滴注。分别于术前、术后7天（D7）及术后1个月（M1）进行简易精神状态量表（MMSE）评估患者的认知功能。术前、手术结束时及术后24小时,采静脉血检测炎症因子IL-1β、IL-8和TNF-α。结果：UTI组术后7天及1月MMSE评分均显著低于CON（P〈0.05）,但POCD的发生率并无明显差异。术后24h时UTI组的IL-β显著低于CON组（P〈0.05）,而IL-8显著高于CON组（P〈0.05）;而TNF-α在各时间点均无显著性差异。结论：围术期应用乌司他丁可有效改善术后认知功能,其作用机制可能与抑制术后炎症反应相关。

英文摘要：

Objective： To observe the effects of ulinastatin on cognitive dysfunction in elderly patients with lower limb joint replacement surgery.Methods： 40 elderly patients undergoing lower limb fracture internal fixation operation patients were randomly divided into 2 groups： Ulinastatin group（UTI group,20）to the start and after 6h were intravenously treated with ulinastatin 200,000U;control group（CON group,20）were given normal saline.Cognitive function of patients in two groups were assessed by Mini-Mental State Examination（MMSE）on preoperative,postoperative day 7（D7） and 1 months postoperatively（M1）.Inflammatory factor IL-1β,IL-8 and TNF-α were detected in preoperative,postoperative and 24 hours after operation.Results： MMSE score in UTI group was significantly lower than those in CON group in D7 and M1（P0.05）,but the incidence of POCD was not significantly different.The IL-1β content of UTI group patients was significantly lower than that of CON group（P0.05）.The IL-8 content of UTI group patients was significantly lower than that of CON group（P0.05） at 24h after operation;The TNF-α contents of two groups were not significantly different.Conclusions： Ulinastatin can effectively improve postoperative cognitive function,the mechanism may be related to inhibiting the inflammation after operation.