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.