Traumatic neuroendocrine dysfunction may present with diabetes insipidus (DI) or with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Both these pathologies involve a disturbance in the antidiuretic hormone (ADH) secretion, causing dysnatremias. Diagnosis of posttraumatic ADH dysfunction is hampered by technical difficulties in ADH assessment, and relies mostly on non-specific serum sodium, serum and urine osmolality and diuresis, often leading to misdiagnosis in the acute care setting. Research now focuses on the diagnostic role of copeptin, a peptide secreted together with ADH in an equimolar fashion, and which can be accurately evaluated. Recent studies identified cut-off values of 2.6 pmol/L for baseline copeptin and of 4.9 and 3.8 pmol/L for hypertonic saline infusion and arginine infusion stimulated copeptin, respectively, for the diagnosis of DI in patients with polyuria-polydipsia syndrome. Although SIADH is more difficult to be explored due to its heterogeneity, a ratio of copeptin to urinary sodium below 30 pmol/mmol identifies euvolemic hyponatremia. Exploring the role of copeptin assessment in patients with traumatic brain injury (TBI) in the acute phase may improve their diagnosis accuracy, management and outcome.

创伤性神经内分泌功能障碍可能表现为尿崩症 (DI) 或抗利尿激素分泌不当综合征 (SIADH)。这两种病理都涉及抗利尿激素 (ADH) 分泌的紊乱，导致钠血症。创伤后 ADH 功能障碍的诊断受到 ADH 评估技术困难的阻碍，并且主要依赖于非特异性血清钠、血清和尿液渗透压和利尿，经常导致急性护理环境中的误诊。现在的研究集中在和肽素的诊断作用，这是一种与 ADH 以等摩尔方式分泌的肽，可以准确评估。最近的研究确定基线和肽素的临界值为 2.6 pmol/L，高渗盐水输注和精氨酸输注刺激的和肽素的临界值为 4.9 和 3.8 pmol/L，分别用于诊断多尿-烦渴综合征患者的DI。尽管 SIADH 由于其异质性而更难探索，但和肽素与尿钠的比率低于 30 pmol/mmol 可识别正常血容量性低钠血症。探索和肽素评估在急性期创伤性脑损伤 (TBI) 患者中的作用可能会提高他们的诊断准确性、管理和结果。