The Clinical Study Of Arginine Vasopressin,Brain Natriuritic Peptide,Nitric Oxide In The Children With Febrile Convulsion

Objective:To detect and analyze the plasma level of antidiuretic hormone,brain natriuretic peptide,nitric oxide and natrum in the children with febrile convulsion, and approach the effect and mechanism of AVP,BNP and NO in the pathogenesis of febrile convulsion.Methods:Fifty six children with febrile convulsion were enrolled in this study, including 24 case of complex febrile convulsion(CFC group) ,32 case of simple febrile convulsion(SFC group),20 case of upper respiratory tract infection (URI group) and 18 health children as the control group were enrolled in this study . the serum levels of AVP and BNP were determined by radioimmunoassay,the serum levels of NO were tested by nitrate reductase method, the serum levels of Na was measured by Full Automatic biochemical analyzer. The statistical analysis was used to compare the difference of each group.Results:1.The plasma AVP level: the AVP level of CFC group and SFC group were higher than URI group and control group . the AVP level of CFC group was significantly higher than SFC group. The difference was significant (p<0.05). There was no statistical difference between the the AVP leves of URI group and control group (p>0.05).2.The plasma BNP level:the level of CFC group was higher than the SFC group ,URI group and control group.The difference was significant (p<0.05). There was no statistical difference among the other three groups (p>0.05).3.The plasma NO level : the level of CFC group was higher than SFC group,URI group and control group.The difference was significant (p<0.05). There was no statistical difference among the other three groups (p>0.05).4.The plasma NA level : the level of CFC group was lower than SFC group,URI group and control group.The difference was significant (p<0.05).There was no significantly difference among the other three groups (p>0.05).5.The correlation analysis between each index : AVP has the positive correlation with body temperature(r=0.71,p<0.01).BNP has the negative correlation with Na (r=-0.62,p<0.01).BNP was the negative correlation with AVP(r=-0.23,p<0.05) .NO was the positive correlation with BNP (r=0.78,p<0.01).Conclusions: 1.Fever can increase the secretion of AVP. AVP could decrease the threshold of fever convulsion, and increase the susceptibility of febrile convulsion. Especially for the children.2.Severely repeated or long-time febrile convulsion could cause cerebral edema and brain injured,which could increase the expression of NO. So that the AVP and BNP secretion of hypothalamus would increase correspondency.3.With the over-expression of NO/NOS expression, the excitability neurotransmitter is increased,the rejection capability neurotransmitter is decreased and oxyradical is generated.This could not only increased the excitability of cerebral cortex,but also reduse the threshold of convulsion and aggravate convulsion and brain injured.4. With the increase of AVP,the renal tubes would reabsord more water,and the osmotic pressure descends and that lead to dilutional hyponatremia。The increase levels of BNP could inhibit the aldosterone system,thas is,the function of keeping sodium and water is decreased,then the body lose more sodium and water.5. AVP could stimulate the secretion of BNP ,but high levels of BNP suppress the secretion of AVP,both of them concomitance adjust the water-electrolyte metabolism,and decrease the sodium level. NO could cause fever and suppress the secretion of AVP in hypothalamus too.Therefore,the AVP combining with BNP and NO,could induce the onset of convulsion and brain injured6.The level of AVP,BNP and NO are much significiantly higher in complex febrile convulsion than simple febrile convulsion.It is helpful to identify the subtypes of febrile convulsion by determining the levels of these useful items.