The effect of ulinastatin on hyperglycemia in patients undergoing hepatectomy

To identify the effect of ulinastatin (UTI) administration on stress-induced hyperglycemia and acute insulin (INS) resistance experienced by patients undergoing partial hepatectomy.

Forty-six patients undergoing partial hepatectomy were assigned randomly to the control group (group C) or UTI treatment group (group U). Six cases underwent partial hepatectomy but were not eligible for inclusion. The patients in group U had an intravenous infusion of a total amount of 5000 IU/kg UTI before the induction of anesthesia and at the start of surgery. The patients in group C were given an identical volume of physiological saline in the same manner. Blood samples for the measurement of interleukin-6, cortisol, INS, and glucagon were obtained. Fasting plasma glucose concentration was measured immediately before skin incision (T1), 20 min after the liver lesion was removed (T2), at the end of surgery (T3), as well as on the first (T4) and second mornings after partial hepatectomy (T5). The insulin sensitivity index (ISI) was calculated at these time points.

The fasting plasma glucose concentration in group U was significantly lower than that in group C at all time points except for T1. In group U, the insulin sensitivity index was higher, and the levels of interleukin-6, cortisol, and INS were lower than that in group C (P < 0.05).

The data suggest that UTI administration improves perioperative hyperglycemia by inhibiting the inflammatory reaction, as well as excessive release of inflammatory factors, and improves INS resistance.