Hamann G, Stober T, Schimrigk K
Department of Neurology, University of the Saarland, Homburg, Federal Republic of Germany.
Acta Neurochir (Wien). 1989;100(1-2):25-30. doi: 10.1007/BF01405269.
The possible relationship between plasma renin activity and neurological deficits was examined in ten patients with spontaneous subarachnoid haemorrhage in a prospective clinical study. The patients were examined daily, particular attention being given to signs of brain stem dysfunction. The degree of impaired consciousness was assessed using the Glasgow Coma Score. Plasma renin activity was determined on days 1-5, 7, 9, 11, 13, 15 and 21 after the initial bleeding episode using an Angiotensin-I-radioimmunoassay. Six of seven patients with signs of brain stem dysfunction displayed a marked increase in plasma renin activity. Thus a significant negative correlation between the degree of consciousness and the plasma renin activity resulted. An explanation for this correlation may be found in the localization of the autonomous centres and the high concentrations of renin in the hypothalamus and brain stem. The individual changes in plasma renin activity have prognostic significance, whereas single estimated plasma renin activities show great inter-individual differences and have only limited prognostic value.
在一项前瞻性临床研究中，对10例自发性蛛网膜下腔出血患者血浆肾素活性与神经功能缺损之间的可能关系进行了研究。每天对患者进行检查，特别关注脑干功能障碍的体征。使用格拉斯哥昏迷评分评估意识障碍程度。在初次出血事件后的第1 - 5天、第7天、第9天、第11天、第13天、第15天和第21天，采用血管紧张素-I放射免疫分析法测定血浆肾素活性。7例有脑干功能障碍体征的患者中有6例血浆肾素活性显著升高。因此，意识程度与血浆肾素活性之间存在显著的负相关。这种相关性的解释可能在于自主神经中枢的定位以及下丘脑和脑干中肾素的高浓度。血浆肾素活性的个体变化具有预后意义，而单次估计的血浆肾素活性个体间差异很大，预后价值有限。
