颅脑损伤患者早期血浆心钠素、精氨酸加压素、超氧化物歧化酶和内皮素含量变化及其临床意义

Changes in plasma atrial natriuretic polypeptide,arginine pitressin,superoxide dismutase,endothelin levels and their clinical significance in patients with head injury

目的：探讨颅脑损伤早期血浆心钠素（ＡＮＰ）、精氨酸加压素（ＡＶＰ）、超氧化物歧化酶（ＳＯＤ）和内皮素（ＥＴ）含量变化及其临床意义。方法：采用放射免疫方法对２０例急性颅脑损伤患者伤后２、１２和２４小时血浆ＡＮＰ、ＡＶＰ、ＳＯＤ和ＥＴ的含量进行测定，并与正常对照组２０例比较。结果：颅脑损伤最初２小时血浆ＡＮＰ有轻度降低，ＡＶＰ、ＳＯＤ和ＥＴ均有轻度升高（Ｐ均＜０．０５）；伤后１２和２４小时血浆ＡＮＰ含量〔（０．４１６±０．０３２）Ｕ／Ｌ和（０．２６６±０．０６６）Ｕ／Ｌ〕均明显低于正常对照组〔（０．６１２±０．０８６）Ｕ／Ｌ，Ｐ＜０．０１和Ｐ＜０．００１〕，而ＡＶＰ的含量〔（１２．６６０±０．３８６）Ｕ／Ｌ和（１６．７１５±４．２７１）Ｕ／Ｌ〕、ＳＯＤ〔（１９３．４１６±２１．３４５）Ｕ／Ｌ和（２３７．９３５±３５．７４３）Ｕ／Ｌ〕和ＥＴ〔（８０．３４５±２２．３３５）ｎｇ／Ｌ和（１２５．８５８±３２．５４１）ｎｇ／Ｌ〕的含量均显著高于正常对照组〔ＡＶＰ（６．２９６±０．９１７）Ｕ／Ｌ，ＳＯＤ（１４５．１０５±１８．０７８）Ｕ／Ｌ，ＥＴ（４６．０９９±１２．１０６）ｎｇ／Ｌ，Ｐ＜０．０１或Ｐ＜０．００１〕。结论?

Objective:To investigate changes in plasma atrial natriuretic polypeptide(ANP),arginine pitressin (AVP),superoxide dismutase (SOD),endothelin (ET) levels and their clinical significance in patients with head injury.Methods:Twenty patients with acute head injury were included in the present study,and 20 healthy volunteers served as controls.Plasma ANP,AVP,SOD,and ET levels were determined at 2,12,and 24 hours after injury.Results:ANP levels declined slightly at 2 hours afterinjury,while AVP,SOD,and ET levels increased (all P<005).At 12,24 hours following injury,ANP levels significantly decreased in patients with acute head injury compared to the controls 〔12 hours:(0416±0032)U/L vs.(0612±0086)U/L,P<001;24 hours:(0266±0066)U/L vs.(0612±0086)U/L,P<0001〕,but plasma AVP,SOD,and ET levels were markedly higher in patients 〔AVP(12660±0386)U/L and (16715±4271)U/L;SOD(193416±21345)U/L and (237935±35743)U/L;ET(80345±22335)ng/L and (125858±32541)ng/L〕 than those in the controls 〔AVP(6296±0917)U/L,P<001 and P<0001;SOD(145105±18078)U/L,P<001 and P<0001;ET(46099±12106)ng/L,P<001 and P<0001〕.Conclusions:The decrease of endogenous ANP levels and the increase of AVP release may be related to the development of secondary brain edema after acute head injury.SOD activity may indirectly reflect the degree of brain tissue injury,and can be regarded as an important index to evaluate patients′ condition and prognosis.In addition,the change in ET may be associated with the stress response.