Yuan Zhi-hua, Zhu Jian-yong, Huang Wei-dong, Jiang Jiu-kun, Lu Yuan-qiang, Xu Miao, Su Wei, Jiang Ting-ying
Department of Emergency, First Affiliated Hospital, Zhejiang University, Hangzhou, China.
Chin J Traumatol. 2010 Feb;13(1):42-5.
To investigate the changes and effects of arginine vasopressin (AVP) in patients with acute traumatic subarachnoid hemorrhage (tSAH).
The plasma and cerebrospinal fluid (CSF) level of AVP, and intracranial 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, GCS was analyzed respectively. Meanwhile, 18 healthy volunteers were recruited as control group.
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+/-1.38 and 34.61+/-21.43 vs 4.13+/-.26, P less than 0.01), and was remarkably higher in GCS less than or equal to 8 group than GCS larger than 8 group (50.96+/-36.81 vs 25.26+/-12.87 and 44.68+/-31.72 vs 23.53+/-10.94, P less than 0.05). The CSF AVP level was correlated with ICP (r eqaul to 0.46, P less than 0.05), but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS (r equal to -0.29, P larger than 0.05 and r equal to -0.32, P larger than 0.05, respectively). The ICP (mm Hg) in tSAH patients was elevated and higher in GCS less than or equal to 8 group than in GCS larger than 8 group (25.9+/-9.7 vs 17.6+/-5.2, P less than 0.05).
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.
探讨急性创伤性蛛网膜下腔出血（tSAH）患者中精氨酸加压素（AVP）的变化及其影响。
对21例tSAH患者在发病后24小时内测定其血浆和脑脊液（CSF）中AVP水平及颅内压（ICP），采用格拉斯哥昏迷量表（GCS）评估患者神经功能状态，分别分析AVP与ICP、GCS之间的相关性。同时，招募18名健康志愿者作为对照组。
与对照组相比，tSAH组患者在24小时内血浆和CSF中AVP水平（pg/ml）显著升高（分别为38.72±24.71 vs 4.54±1.38和34.61±21.43 vs 4.13±0.26，P＜0.01），且GCS评分≤8分的患者AVP水平显著高于GCS评分＞8分的患者（分别为50.96±36.81 vs 25.26±12.87和44.68±31.72 vs 23.53±10.94，P＜0.05）。CSF中AVP水平与ICP相关（r = 0.46，P＜0.05），但血浆AVP、CSF AVP与初始GCS之间无统计学显著相关性（r分别为-0.29，P＞0.05和r为-0.32，P＞0.05）。tSAH患者的ICP（mmHg）升高，且GCS评分≤8分的患者高于GCS评分＞8分的患者（25.9±9.7 vs 17.6±5.2，P＜0.05）。
我们的研究表明，AVP与tSAH的严重程度相关，可能参与了tSAH后早期脑损伤的病理生理过程。似乎与血浆AVP浓度相比，CSF AVP与tSAH的严重程度更相关。
