Gao Yufeng, Fu Xiaojie, Yu Lie, Zhang Di, Lu Zhengfang, Cui Kefei, Liu Chang, Man Jiang, Wang Jianping
Department of Neurology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Neurointervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Evid Based Complement Alternat Med. 2021 Sep 27;2021:1186458. doi: 10.1155/2021/1186458. eCollection 2021.
Spontaneous intracerebral hemorrhage (ICH) is a blood clot arising in the brain parenchyma in the absence of trauma or surgery and accounts for 10% to 15% of all strokes, leading to higher rates of mortality and morbidity than either ischemic stroke or subarachnoid hemorrhage. We sought to investigate the potential association of DOCK1 with neurological deficits and outcomes in patients with spontaneous ICH.
Identification of methylation-regulated differentially expressed genes (MeDEGs) between ICH patients and matched controls was performed by analyzing the raw data from the GSE179759 and GSE125512 datasets deposited in the Gene Expression Omnibus. A total of 114 patients who were admitted to our hospital for spontaneous ICH were retrospectively analyzed, with 108 healthy volunteers who had received physical examinations at the same period as controls. The mRNA expression of DOCK1 was determined by quantitative real-time polymerase chain reaction (qRT-PCR). The hematoma volume was calculated according to the Coniglobus formula. The severity of neurological deficits was evaluated using National Institutes of Health Stroke Scale (NIHSS) scores and function outcomes were evaluated by modified Rankin Scale (mRS) scores.
A total of 15 MeDEGs between ICH patients and matched controls were identified. The mRNA expression of DOCK1 was remarkably higher in the serum samples of patients with spontaneous ICH than in the healthy controls. According to hematoma volume after ICH attack, small (<10 mL), medium (10 to 30 mL), and large (>30 mL) groups were arranged. The proportions of male patients and patients aged ≥60 years were significantly higher in the large group than in the small and medium groups ( < 0.05). The mRNA expression of DOCK1 was significantly higher in the large group than in the small and medium groups ( < 0.05). According to NIHSS scores, mild (NIHSS scores ≤15), moderate (NIHSS scores from 16 to 30), and severe (NIHSS scores from 31 to 45) groups were classified. It was observed that the severe group had higher proportions of male patients and patients aged ≥60 years than the mild and moderate groups ( < 0.05). The severe group exhibited a higher mRNA expression of DOCK1 than the mild and moderate groups ( < 0.05). According to mRS scores, higher proportions of male patients and patients aged ≥60 years were observed in the unfavorable group than the favorable group ( < 0.05). The patients in the unfavorable group showed an elevated DOCK1 mRNA expression compared to those in the favorable group ( < 0.05).
The study provided evidence that male gender, older age, and higher DOCK1 mRNA expression were related to higher admission hematoma volume, neurologic deterioration, and poor function outcomes in patients with spontaneous ICH.
自发性脑出血(ICH)是指在无创伤或手术情况下脑实质内形成的血凝块,占所有中风的10%至15%,其死亡率和发病率高于缺血性中风或蛛网膜下腔出血。我们试图研究DOCK1与自发性ICH患者神经功能缺损及预后之间的潜在关联。
通过分析基因表达综合数据库中GSE179759和GSE125512数据集的原始数据,鉴定ICH患者与匹配对照之间的甲基化调节差异表达基因(MeDEGs)。对我院收治的114例自发性ICH患者进行回顾性分析,以同期接受体检的108名健康志愿者作为对照。采用定量实时聚合酶链反应(qRT-PCR)测定DOCK1的mRNA表达。根据Coniglobus公式计算血肿体积。使用美国国立卫生研究院卒中量表(NIHSS)评分评估神经功能缺损的严重程度,并用改良Rankin量表(mRS)评分评估功能预后。
共鉴定出ICH患者与匹配对照之间的15个MeDEGs。自发性ICH患者血清样本中DOCK1的mRNA表达显著高于健康对照。根据ICH发作后的血肿体积,分为小血肿组(<10 mL)、中等血肿组(10至30 mL)和大血肿组(>30 mL)。大血肿组男性患者和年龄≥60岁患者的比例显著高于小血肿组和中等血肿组(P<0.05)。大血肿组DOCK1的mRNA表达显著高于小血肿组和中等血肿组(P<0.05)。根据NIHSS评分,分为轻度组(NIHSS评分≤15)、中度组(NIHSS评分16至30)和重度组(NIHSS评分31至45)。观察到重度组男性患者和年龄≥60岁患者的比例高于轻度组和中度组(P<0.05)。重度组DOCK1的mRNA表达高于轻度组和中度组(P<0.05)。根据mRS评分,预后不良组男性患者和年龄≥60岁患者的比例高于预后良好组(P<0.05)。与预后良好组相比,预后不良组患者的DOCK1 mRNA表达升高(P<0.05)。
该研究提供了证据,表明男性、老年以及较高的DOCK1 mRNA表达与自发性ICH患者较高的入院时血肿体积、神经功能恶化及功能预后不良有关。