Beuth W, Kasprzak H, Kotschy M, Woźniak B, Kulwas A, Sniegocki M
Katedry i Kliniki Neurochirurgii, Akademia Medyczna im. L. Rydygiera w Bydgoszczy.
Neurol Neurochir Pol. 2001;35 Suppl 5:125-9.
Endothelin (ET) is identified as a potent vasoconstrictor peptide. It can cause a cerebral vasospam after subarachnoid hemorrhage. Its long-lasting vasoconstricting activity has been well documented. The role of ET in response to head injury is not clear. ET can participate in astrocyte activation and oxidative stress after trauma. The aim of this presentation was to investigate ET in the plasma and cerebrospinal fluid of patients after head injury and estimation of relation between the ET csf level and clinical condition of the patients and also relation of ET csf level and changes in the CT-scan and usefulness of ET as independent prognostic factor. We examined 30 patients at Day 1 after trauma (28 male, 2 female, aged 19-34 y, mean 30, 4, GCS ranged 8-15). CT-examination showed post-traumatic changes in 19 cases (11 with brain edema only, 8 with brain contusion). We measured ET by immunoenzymatic method using standard kits (Biomedica). The ET plasma level reached 1.12 +/- 0.63 fmol/ml (in the control group--0.44 +/- 0.19 fmol/ml) and c ET csf level 1.03 +/- 0.49 (in the control group--0.07 +/- 0.09 fmol/ml). W confirmed the correlation between the ET level and patients consciousness (by GCS) (p < 0.01). The ET csf level was highest in the patients with brain contusion in CT-scan (p < 0.02). Using multivariate analyses, we showed that ET can be used as a prognostic factor of results of treatment (p < 0.02).
The ET level is elevated in the plasma of patients after head injury. ET is also present and strongly elevated in the cerebrospinal fluid of the same patients. The ET level in cerebrospinal fluid is associated with clinical condition of patients and elevated in cases with brain edema and structural brain damage. The ET level in cerebrospinal fluid is related to post-traumatic changes of the brain such as oedema and structural damage present in the CT-scan. ET can be used as a prognostic factor of results of treatment.
内皮素（ET）被鉴定为一种强效血管收缩肽。蛛网膜下腔出血后它可引起脑血管痉挛。其持久的血管收缩活性已有充分记录。ET在颅脑损伤反应中的作用尚不清楚。ET可参与创伤后星形胶质细胞活化和氧化应激。本报告的目的是研究颅脑损伤患者血浆和脑脊液中的ET，并评估ET脑脊液水平与患者临床状况之间的关系，以及ET脑脊液水平与CT扫描变化之间的关系，以及ET作为独立预后因素的有用性。我们在创伤后第1天检查了30例患者（28例男性，2例女性，年龄19 - 34岁，平均30.4岁，格拉斯哥昏迷评分范围为8 - 15）。CT检查显示19例有创伤后改变（11例仅有脑水肿，8例有脑挫裂伤）。我们使用标准试剂盒（Biomedica）通过免疫酶法测量ET。ET血浆水平达到1.12±0.63 fmol/ml（对照组为0.44±0.19 fmol/ml），ET脑脊液水平为1.03±0.49（对照组为0.07±0.09 fmol/ml）。我们证实了ET水平与患者意识（通过格拉斯哥昏迷评分）之间的相关性（p < 0.01）。CT扫描显示脑挫裂伤的患者ET脑脊液水平最高（p < 0.02）。通过多变量分析，我们表明ET可作为治疗结果的预后因素（p < 0.02）。
颅脑损伤患者血浆中ET水平升高。同一患者的脑脊液中也存在ET且显著升高。脑脊液中ET水平与患者临床状况相关，在脑水肿和脑结构损伤的病例中升高。脑脊液中ET水平与创伤后脑的改变有关，如CT扫描中出现的水肿和结构损伤。ET可作为治疗结果的预后因素。
