Early changes of endothelin and nitric oxide in patients with acute brain injury / 中华创伤杂志

ABSTRACT

Objective　To investigate the early changes and clinical significance of plasma endothelin(ET) and nitric oxide(NO) in patients with acute brain injury.　Methods　The plasma ET and NO concentration at 1 day after injury were checked with radioimmunoassay and Green method in 48 cases of acute brain injury, in 42 cases of non-brain injury and in 38 healthy volunteers. 　Results　 The early plasma concentrations of ET and NO were (109.73±12.61) ng/Lf and (92.82±18.21) μmol/L, respectively, in 48 cases of acute cerebral injury, which were higher than those in the non-brain injury group［(67.90±11.33) ng/L and (52.66±12.82) μmol/L, respectively, P<0.01］ and in the normal control group ［(50.65±17.12)ng/L and (36.12±12.16) μmol/L, respectively, P<0.001］. The amounts of ET and NO in the patients with severe brain injury were (116.18±18.12) ng/L and (108.19±13.28) μmol/L, respectively, which were significantly higher than that of the moderate brain injury group［(92.33±16.32) ng/L and (76.38±12.71) μmol/L, respectively, P<0.01］.The early levels of ET and NO were negatively related to the GCS scores of the patients with acute brain injury. The amounts of ET and NO were (126.23±15.23)ng/l and (118.18±10.12) μmol/L, respectively, in the patients with subdural hematomas, which were significantly higher than those in the patients with epidural hematomas ［(81.13±12.37) ng/L and(68.02±13.18) μmol/L, respectively, P<0.01］. The stable plasma concentrations of ET and NO at 14 days after injury in the patients with acute brain injury and with non-brain injury were similar to that in the normal controls. 　Conclusions　 ET and NO are related to the pathophysiological process in the early period of acute brain injury, and the values of ET and NO correlate positively with the clinical manifestations. The changes of plasma ET and NO can be regarded as important indexes to diagnose the severity of acute brain injury.