Early changes of endothelin, nitric oxide and arginine-vasopressin in patients with acute cerebral injury.
OBJECTIVE
To investigate the early changes and clinical significance of plasma endothelin (ET), nitric oxide (NO) and arginine-vasopressin (AVP) in patients with acute moderate or severe cerebral injury.


METHODS
The early (at 24 hours after injury) plasma concentrations of ET, NO and AVP were measured with radioimmunoassay and Green technique in 48 cases of acute moderate (GCS<or=8 in 27 cases ) or severe (GCS>8 in 21 cases) cerebral injury (Group A), in 42 cases of non-cerebral injury (Group B) and in 38 normal individuals (Group C), respectively.


RESULTS
The early plasma concentrations of ET (109.73 ng/L+/-12.61 ng/L), NO (92.82 micromol/L+/-18.21 micromol/L ) and AVP (49.78 ng/L+/-14.29 ng/L) in Group A were higher than those in Group B (67.90 ng/L+/-11.33 ng/L, 52.66 micromol/L+/-12.82 micromol/L and 29.93 ng/L+/-12.11 ng/L, respectively, P<0.01) and Group C (50.65 ng/L+/-17.12 ng/L, 36.12 micromol/L+/-2.16 micromol/L and 5.18 ng/L+/-4.18 ng/L, respectively, P<0.001 ). The amounts of ET, NO and AVP in patients with severe cerebral injury were 116.18 ng/L+/-18.12 ng/L, 108.19 micromol/L+/-13.28 micromol/L and 58.13 ng/L+/-16.78 ng/L, respectively, which were significantly higher than that of the patients with moderate cerebral injury (92.33 ng/L+/-16.32 ng/L, 76.38 micromol/L+/-12.71 micromol/L and 36.18 ng/L+/-12.13 ng/L respectively, P<0.01 ). The early levels of ET, NO and AVP in Group A were negatively related to the GCS scales. The amounts of ET, NO and AVP were 126.23 ng/L+/-15.23 ng/L, 118.18 micromol/L+/-10.12 micromol/L and 63.49 ng/L+/-14.36 ng/L respectively in patients with subdural hematoma, which were significantly higher than those in patients with epidural hematoma (81.13 ng/L+/-12.37 ng/L, 68.02 micromol/L+/-13.18 micromol/L and 45.63 ng/L+/-12.41 ng/L respectively, P<0.01). The plasma concentrations of ET, NO and AVP in stable duration (at 336 hours after injury) in Group A and Group B were similar to those in Group C.


CONCLUSIONS
ET, NO and AVP were related to the pathophysiological process that occurs in the early stage of acute cerebral injury and the values of ET, NO and AVP correlate positively with the clinical manifestations. The changes of plasma ET, NO and AVP can be regarded as important indices to assess the severity of acute cerebral injury.
Yang
Yunmei
Y
Department of Emergency, First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou 310003, China.
Huang
Weidong
W
Lü
Xueying
X
D000293:Adolescent; D000328:Adult; D001127:Arginine Vasopressin / Q000097:blood*; D001930:Brain Injuries / Q000097:blood* / Q000503:physiopathology; D016232:Endothelins / Q000097:blood*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood; D009569:Nitric Oxide / Q000097:blood*
D016232:Endothelins; D001127:Arginine Vasopressin; D009569:Nitric Oxide