[Dynamics of parameters of autonomous regulation, humoral immunity and neuroendocrine system in acute brain injury with fatal outcome].
Twenty-two patients with brain injury who died within 24 days after admission to the hospital were studied. Autonomous regulation was studied using a method of variation cardiointervalography (VCIG), humoral immunity - by a method of gel radial immunodiffusion, contents of adrenocorticotropic hormone (ACTH) and hydrocortisone - by a radioimmune method. VCIG registration and blood sampling were carried out in the morning in 1-3, 4-6, 7-10, 11-14, 15-18 and 19-22 days after admission to the hospital. A control group included 10 healthy people. A comparison group consisted of 15 patients survived after the severe brain injury. In patients with the fatal brain injury, the duration of adrenocortical stage was on average 3 weeks that was comparable to the parameters of survived patients. The immunological reactions were characterized by relatively higher concentrations of immunoglobulins in the first days of admission. In the following days, their levels fell down. The death occurred mostly in the 1st week when the levels of ACTH and cortisol in the peripheral blood and parameters of sympatic tone were maximal that might indicate the overstrain of autonomous and endocrine systems and in the 19-22 days in the period of the dramatic reduction of hormone production (immunological hole) and exhaustion of adaptive-compensation mechanisms as revealed by VCIG data.
Kravtsov
Iu I
IuI
Shevchenko
K V
KV
Chetvertnykh
V A
VA
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001930:Brain Injuries / Q000276:immunology / Q000401:mortality / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D056724:Immunity, Humoral / Q000276:immunology*; D005779:Immunodiffusion; D007136:Immunoglobulins / Q000097:blood; D008297:Male; D009490:Neurosecretory Systems / Q000378:metabolism*; D012426:Russia / Q000453:epidemiology; D015996:Survival Rate
D007136:Immunoglobulins; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone