Early change of plasma and cerebrospinal fluid arginine vasopressin in traumatic subarachnoid hemorrhage

• Published in: Chinese journal of traumatology Vol. 13; no. 1; pp. 42 - 45
• Main Author: 袁志华 祝建勇 黄卫东 姜久昆 陆远强 徐妙 苏伟 蒋挺英
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.02.2010; Department of Emergency,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China%Department of Critical Care Medicine,Sir Run Run Shaw Hospital,University of Zhejiang,Hangzhou 310016,China%Institute of Radioimmunology Center,Hangzhou 310015,China
• Subjects: Adult; Arginine vasopressin; Arginine Vasopressin - blood; Arginine Vasopressin - cerebrospinal fluid; AVP; Female; Glasgow Coma Scale; Humans; Intracranial Pressure; Male; Middle Aged; Subarachnoid hemorrhage, traumatic; Subarachnoid Hemorrhage, Traumatic - metabolism; 外伤性; 精氨酸加压素; 脑脊液; 蛛网膜下腔; Glasgow coma scale; Intracranial pressure; Arginine vasopressin; Subarachnoid hemorrhage, traumatic; Subarachnoid hemorrhage,traumatic
• ISSN: 1008-1275
• DOI: 10.3760/cma.j.issn.1008-1275.2010.01.008

Objective： To investigate the changes and effects of arginine vasopressin （AVP） in patients with acute traumatic subarachnoid hemorrhage （tSAH）. Methods： 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. Results： 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± 1.26, P〈0.01）, and was remarkably higher in GCS ≤8 group than GCS〉8 group （50.96±36.81 vs 25.26±12.87 and 44.68±31.72 vs 23.53±10.94, P〈0.05）. The CSF AVP level was correlated with ICP （r= 0.46, P〈0.05）, but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS （r= -0.29, P〉0.05 and r= -0.32, P〉0.05, respectively）. The ICP （ram Hg） in tSAH patients was elevated and higher in GCS ≤ 8 group than in GCS〉8 group （25.9±9.7 vs 17.6±5.2, P〈0.05）. Conclusion： Our research suggests that AVP is correlated with the severity oftSAH, 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 oftSAH.