Vasopressin and oxytocin in CSF and plasma of patients with aneurysmal subarachnoid haemorrhage
Vasopressin and oxytocin in CSF and plasma of patients with aneurysmal subarachnoid haemorrhage
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DOI：
10.1016/j.npep.2013.12.004
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发表时间：
2014-04-01
期刊：
影响因子：
2.9
通讯作者：
Landgraf, Rainer
中科院分区：
文献类型：
--
作者：
Martin, Jan;Kagerbauer, Simone M.;Landgraf, Rainer
目的：蛛网膜下腔出血（SAH）患者的临床病理研究显示下丘脑病变。下丘脑神经肽精氨酸加压素（AVP）和催产素（OXT）与蛛网膜下腔出血的关系尚不清楚。本研究旨在探讨自发性蛛网膜下腔出血患者脑脊液和血浆中AVP和OXT的变化及其与预后的关系。放免法测定AVP和OXT。结果采用Morgow-Outcome-Scale进行评估。29例无神经精神障碍的患者作为对照。神经肽浓度的时间进程的差异进行了评估回归模型。组比较进行了Kruskal-Wallis和相关性斯皮尔曼test.Results：预后差和良好的患者之间的CSF水平回归显示AVP水平显着降低患者预后差（p = 0.012），而OXT显示出降低水平的趋势（p = 0.063）。在血浆中，结果组之间没有发现显著差异。结果差的患者和对照组之间的组比较显示，AVP（p = 0.001）和OXT（p = 0.015）的CSF有显著差异。在血浆中，AVP产生了显着不同的结果，而OXT没有。结果良好组和对照组之间没有差异。结论：SAH预后差的患者CSF中AVP和OXT水平低于预后好的患者，而血浆神经肽水平不能反映预后的差异。这些数据表明下丘脑损伤是蛛网膜下腔出血后预后的一个病因因素。(C)2014爱思唯尔有限公司版权所有。
Objective: Clinicopathological studies on patients succumbing to subarachnoid haemorrhage (SAH) demonstrated hypothalamic lesions. The implication of the hypothalamic neuropeptides arginine-vasopressin (AVP) and oxytocin (OXT) has not been linked to aneurysmal SAH yet. This study investigates AVP and OXT in CSF and plasma of patients with spontaneous aneurysmal SAH and their association with outcome.Methods: CSF and plasma samples of 12 patients with aneurysmal SAH were prospectively studied for 2 weeks. AVP and OXT were measured by radioimmunoassay. Outcome was assessed on Glasgow-Outcome-Scale. Twenty-nine patients without neuropsychiatric disturbances served as controls. Differences in neuropeptide concentration time courses were assessed by regression models. Group comparisons were performed by Kruskal-Wallis and correlations by Spearman tests.Results: Regression of CSF levels between patients with poor and good outcome revealed significantly lower levels of AVP in patients with poor outcome (p = 0.012) while OXT showed a trend towards lower levels (p = 0.063). In plasma, no significant differences between outcome groups were found. Group comparisons between poor outcome patients and controls revealed significant differences in CSF for AVP (p = 0.001) and OXT (p = 0.015). In plasma, AVP yielded significantly different results while OXT did not. No differences were found between the good outcome group and controls. Plasma and CSF concentrations showed no significant correlation.Conclusion: Patients with poor outcome after aneurysmal SAH have lower AVP and OXT levels in CSF than patients with good outcome while neuropeptide levels in plasma failed to reflect differences in outcome. The data indicate hypothalamic damage as an aetiologic factor for outcome after aneurysmal SAH. (C) 2014 Elsevier Ltd. All rights reserved.