Plasma Concentrations Of Neurotensin And Endothelin After Traumatic Brain Injury And The Correlation With Acute Gastrointestinal Lesions In Human Patients

Objective To investigate the changes in plasma endothelin(ET) and neurotensin(NT) after traumatic brain injury(TBI) in humans, with special regard to the presence of acute gastrointestinal lesions.Methods Plasma levels of ET and NT were measured by radioimmunoassay(RIA) in 64 patients with TBI on day 1 after admission.Fasting plasma levels of ET and NT on days 3,5,7,10 in the patients above and 15 healthy people were also detected. Meanwhile the clinical outcomes of acute gastrointestinal lesion were observed through laboratory examination.Results Incidence of acute gastrointestinal lesion of severe group was higher than moderate group(P < 0.05). The physiopathologic condition was also more serious. The plasma levels of NT and ET initially increased significantly (moderate group P < 0.05; severe group P < 0.01 vs. control),then decreased apparently from day 3, after a smooth decline, NT concentration dropped to the bottom,while ET showed a second peak on the beginning of the second week(moderate group P < 0.05; severe group P < 0.01 vs. control),then increased slowly. Compared with the moderate group,the plasma levels of NT were significantly higher on day 1 and significantly lower on day 7(severe group P < 0.01),while the ET showed biphasic elevation(severe group P < 0.01). When compared the TBI combined with gastrointestinal lesions group with the isolated TBI group, the similar changes happened. In addition,there was a significant linear correlation between plasma NT,ET and GCS of severe TBI patients.Conclusions There is a significant correlation between TBI and gastrointestinal lesions after injury.To some extent, the plasma concentrations of NT and ET participate in the physiopathologic course after TBI. NT and ET play an important role on the protection and injury of gastrointestine after TBI.