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Early change of plasma and cerebrospinal fluid arginine vasopressin in traumatic subarachnoid hemorrhage
Authors:YUAN Zhi-hua  ZHU Jian-yong  HUANG Wei-dong  JIANG Jiu-kun  LU Yuan-qiang  XU Miao  SU Wei  JIANG Ting-ying
Affiliation:[1]Department of Emergency, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China [2]Department of Critical Care Medicine, Sir Run Run Shaw Hospital, University of Zhejiang, Hangzhou 310016, China [3]Institute of Radioimmunology Center, Hangzhou 310015, China
Abstract:
Objective:To investigate the changes and effects of arginine vasopressin(AVP)in patients with acute traumatic subarachnoid hemorrhage(tSAH).Methods:The plasma and cerebrospinal fluid(CSF)level of AVP,and intracraniai pressure(ICP)were measured in a total of 21 patients within 24 hours after tSAH.The neurological status of the patients was evaluated by Glasgow Coma Scale(GCS).Correlation between AVP and ICP,CrCS was analyzed respectively.Meanwhile,18 healthy volunteers were recruited as control group.Results:Compared with control group,the levels(pg/ml)of AVP in plasma and CSF((x)±s)in tSAH group were significantly increased within 24 hours(38.72±24.71 vs 4.54±1.38and 34.61±21.43 vs 4.13±1.26,P<0.01),and was remarkably higher in GCS≤8 group than GCS>8 group(50.96±36.81 vs 25.26±12.87 and 44.68±31.72 vs 23.53±10.94,P<0.05).The CSF AVP level was correlated with ICP(r= 0.46,P<0.05),but no statistically significant correlation was found between plasma AVP,CSF AVP and initial GCS(r=-0.29,P>0.05 and r=-0.32,P>0.05,respectively).The ICP(mm Hg)in tSAH patients was elevated and higher in GCS≤8 group than in GCS>8 group(25.9±9.7 vs 17.6±5.2,P<0.05=.Conclusion:Our research suggests that AVP is correlated with the severity of tSAH,and may be involved in the pathophysiological process of brain damage in the early stage after tSAH.It seems that compared with the plasma AVP concentration,CSF AVP is more related to the severity of tSAH.
Keywords:Arginine vasopressin  Subarachnoid hemorrhage,traumatic  Glasgow coma scale  Intracranial pressure
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