Early changes of arginine vasopressin and angiotensin II in patients with acute cerebral injury

ＡＤｅｐａｒｔｍｅｎｔｏｆＥｍｅｒｇｅｎｃｙ ,ＳｉｒＲｕｎＲｕｎＳｈａｗＨｏｓｐｉｔａｌ,ＭｅｄｉｃａｌＣｏｌｌｅｇｅ ,ＺｈｅｊｉａｎｇＵｎｉｖｅｒｓｉｔｙ ,Ｈａｎｇｚｈｏｕ 310 0 16 ,Ｃｈｉｎａ(ＨｕａｎｇＷＤ ,ＷｕＳＤ ,ＪｉｎＺＦａｎｄＢａｏＤＧ)ＤｅｐａｒｔｍｅｎｔｏｆＥｍｅｒｇｅｎｃｙ ,ＦｉｒｓｔＡｆｆｌｉａｔｅｄＨｏｓｐｉｔａｌ,ＭｅｄｉｃａｌＣｏｌｌｅｇｅ ,ＺｈｅｊｉａｎｇＵｎｉｖｅｒｓｉｔｙ ,Ｈａｎｇｚｈｏｕ 310 0 0 3 ,Ｃｈｉｎａ(ＹａｎｇＹＭ)ＤｅｐａｒｔｍｅｎｔｏｆＮｅｕｒｏｓｕｒｇ…

Early changes of arginine vasopressin and angiotensin II in patients with acute cerebral injury

Objective:　To study the changes and clinical significance of arginine vasopressin (AVP) and angiotensin II (AT-II) in patients with acute moderate and severe cerebral injury. 　　Methods:　The early plasma concentration was checked by radioimmunoassay in 47 cases of acute moderate and severe cerebral injury, 30 cases of non-cerebral injury and 30 healthy volunteers. 　　Results:　The early plasma concentrations of AVP (50.23 ng/L±15.31 ng/L) and AT-II (248.18 ng/L±82.47 ng/L) in cerebral injury group were higher than those in non-cerebral injury group (AVP for 30.91 ng/L±11.48 ng/L and AT-II for 120.67 ng/L±42.49 ng/L, P<0.01). The early plasma concentrations of AVP and AT-II in cerebral injury group were also obviously higher than those of the volunteers (AVP for 5.16 ng/L±4.23 ng/L and AT-II for 43.11 ng/L±16.39 ng/L, P<0.001). At the same time, the early plasma level of AVP (58.90 ng/L±18.12 ng/L) and AT-II (292.13 ng/L±101.17 ng/L) was higher in severe cerebral injured patients than moderate cerebral injured ones (AVP for 36.68 ng/L±12.16 ng/L and AT-II for 201.42 ng/L±66.10 ng/L, P<0.01). The early level of AVP and AT-II was negatively related to the GCS scales in acute cerebral injury. The early plasma concentrations of AVP (45.98 ng/L±13.48 ng/L) and AT-II (263.28 ng/L±80.23 ng/L) were lower in epidural hematoma group than those of subdural hematoma and cerebral injury group (AVP for 64.12 ng/L±15.56 ng/L and AT-II for 319.82 ng/L±108.11 ng/L, P<0.01). 　　Conclusions:　 AVP and AT-II may play an important role in pathophysiologic process in the secondary cerebral injury. The more severe the cerebral injury is, the higher the early level of AVP and AT-II will be. The early plasma level of AVP and AT-II may be one of the severity indexes of cerebral injury.