Objective    To compare the effects of aprotinin and ulinastatin on antai-inflammatory in patients who undergoing cardiac valve replacement with extracorporeal circulation (ECC).     Methods    Sixty ASAⅡ to Ⅲ patients who underwent cardiac vavle replacement from June 2006 to March 2008 were randomly divided into 3 groups: ulinastatin group (group U

n=20)

aprotinin group (group A

n=20) and control group (group C

n=20). Half dose of ulinastatin (2×10

4

U/kg) and aprotini

n (56 U/kg) was given to corresponding groups 10 min before ECC

and the left half was added into priming solution

and control groups received normal saline at the same volume. The intravenous blood samples were taken from 15 min before ECC (T1)

10 min after opening ascending aorta (T2)

30 min after discontinuation of ECC (T3) and 60 min after discontinuation of ECC (T4)

and the plasma concentrations of IL-6

IL-8

IL-10 and TNF-α were detected to analyze the changes of the inflammatory factors in each group at 4 time points.     Results    The plasma concentrations of IL-6

IL-8

IL-10 and TNF-α were significantly higher at time points T2

T3 and T4 than at T1. The plasma concentrations of IL-6

IL-8 and TNF-α at time points T2

T3 and T4 were significantly lower in group U than group A and group C (P0.05

0.01)

and these concentrations in Group A were lower than in group C (P0.05). The plasma concentration of IL-10 at time points T2

T3 and T4 in group U and group A were significantly higher than in group C (P0.05

0.01)

with the former group significantly lower than the later(P0.05).      Conclusion    Ulinastatin and aprotinin inhibits the inflammatory factors induced by ECC

and improves the expressions of anti-inflammatory factors. Ulinastatin is more effective than aprotinin in inhibiting the inflammatory factors. However

aprotinin is more effective than ulinastatin in upregulating the expressions of anti-inflammatory factors. Both of them can effectively suppress ECC-induced inflammatory response.