| Objectives:The purpose of this study is to study the changes of neurobehavior,blood cell and serum protein in patients with spontaneous subarachnoid hemorrhage and the effect of these changes on neurobehavior,and provide experimental basis for the prevention,treatment and mechanism studying of the aneurysm spontaneous subarachnoid hemorrhage disease.Methods:A total of 61 patients(24 males and 37 females,ages ranging from 20 to 81 years old,the average age was 55.46 ± 13.49)of aneurysm spontaneous subarachnoid hemorrhage who were recruited and confirmed by neurosurgery from First People's Hospital in Kunming,Yunnan Province from November 2014 to April 2017.For these patients who entered the hospital within 24h from attack,the whole blood and serum from them was collected when they entered the hospital(patients received no treatment),and the whole blood was used for emergency blood cell analysis,serum was used for protein chip analysis.The patients were graded according to the corresponding time points.The patients who were admitted into the hospital immediately and divided into mildness group and seriousness one based on Hunt-Hess classification.Patients with light and serious aneurysm spontaneous subarachnoid hemorrhage,were compared with the normalcontrol,respectively.Moreover,serious and light aSAH patients were compared w:ith each other.The data of blood cells and serum protein from the corresponding time points in each group was analyzed by t-test and bioinformatics method respectively.Results:(1)The blood cell analysis from patients who wre admitted into the hospital immediately showed that:? The comparison between mildness patient group and the control,HGB,RBC,WBC,NEUT%and NEUT#showed an increasing trend,and the difference had statistical significance(p<0.05);CLYM%,MONO%,CLYM#and MONO#were decreased,the difference had statistical significance(p<0.01);comparison of PLT between the same two groups above mentioned showed no significant statistical difference(p>0.05).?Comparison between seriousness patient group and the control,HGB,RBC,WBC,NEUT%and NEUT#showed an increasing trend,and the difference had substantially statistical significance(p<0.01);CLYM%,MONO%and CLYM#were decreased,the difference had obviously statistical significance(p<0.01);Comparison between MONO#and PLT revealed there was no markedly statistical difference(p>0.05).? WBC,NEUT#and MONO#from seriousness patient group were higher than the mildness patient group,the difference had obviously statistical significance(p<0.01);Comparison of HGB,RBC,NEUT%,CLYM%,MONO%,CLYM#and PLT showed there was no significantly statistical difference(p>0.05).(2)The serum protein chip analysis from patients who were admitted into the hospital immediately showed that:? Comparison between mildness patient group and the control revealed that,there were 113 serum proteins elevated,and the top ten proteins were ROS,RYK,S100A10,uPA,EphB2,LTK,EphAS,Cathepsin B,EphA8 and Desmin;The expression of 352 serum proteins was down-regulated,and the top ten were Pro-BDNF,IL-36RN,Fetuin B,NM23-H1/H2,PAK7,TFF3,HTRA2,CD36,MCP-4/CCL13 and Activin RIIA.? Comparison between seriousness patient group and the control,130 serum proteins were found to be up regulated.The top ten proteins were BAFF R/TNFRSF13C,EN-RAGE,IGFBP-5,BLAME,FGFR2,IL-1 F8/FIL1 eta,SCG3,MMP-9,Kallikrein 7 and Btk.A total of 192 serum proteins were down regulated,the top ten were OX40,HTRA2,CCR7,M-CSF,IL-23R,Activin RIB/ALK-4,IGFBP-6,IL-1 ra,MFRP and IL-17C,respectively.?Comparison between seriousness group and mildness one,a total of 248 serum proteins were up regulated,and the top ten proteins were Fetuin B,IL-36RN,NM23-H1/H2,CD36,CPN2,VWF,DCBLD2,Follistatin-like 1,Btk,FER.A total of 112 serum proteins were down regulated,and the top ten were ROS,CD74,Desmin,RYK,LTK,pro-Glucagon,uPA,Cathepsin B,EphB2 and EphA8.? The top 10 up or down regulated proteins were selected severally that according to the fold change from the comparison among three groups and then were put into String website to search the interaction between proteins The protein microarray analysis results from three groups overlapped each other.We found that when the mildness patients compared with the control,the Fetuin B,IL-36RN,NM23-H1/H2 and CD36 protein were lowered obviously,ROS,RYK,uPA,EphB2,LTK,Cathepsin B,EphA8 and Desmin raised obviously,and we got the same results when compared the mildness patients with the seriousness ones.However,for comparison of the seriousness patients with the control,the expression of Fetuin B and uPA were up regulated,the'expression of IL-36RN,NM23-H1/H2,CD36,ROS,RYK,EphB2,LTK,Cathepsin B,EphA8 and Desmin had no obvious change.Meanwhile,when compared the seriousness patients with the control,Btk protein significantly up regulated,and also raised obviously that compared with the mildness patients.Howerer,as for comparison the mildness patients with the control,there was no obvious change.Moreover,EphB2 and RYK protein existed a direct relationship.Conclusions:(1)Once aSAH occurs,the neurobehavior changes.The mildness patients show neurologic involvement and meningeal stimulation.The seriousness ones turn out to be neurological disorders,consciousness barrier and meningeal stimulation,and even appear hemiplegia.aSAH also cause nerve function damage,such as impaired cognitive function,especially the executive function,language and spatial memory.(2)When aSAH is outbreaking,HGB,RBC,WBC,NEUT%and NEUT#are increased,CLYM%,MONO%,CLYM#and MONO#are reduced,and among them,the WBC,CLYM#and MONO#are related to neural behavior,the illness is more severe,the more the number of these cells,the more extent of inflammation,and the more serious of the damage to nerve function.(3)When aSAH is outbreaking,there is a variety of serum protein changed,which is a complicated adjustment process.Among them,the functions of proteins which is associated with ischemia and hypoxia,immune inflammation,apoptosis or growth,vascular damage or repair.At this time,neurological function are changed most significantly.The expression changes of these proteins may be associated with the severity of the disease or may be a potential pathogenesis of this disease,it remains to be further elucidate(4)When aSAH is outbreaking,hemorrhagic and traumatic acute stress inflammatory response generated can bring damage to the blood vessels,and then,cause ischemia and hypoxia in local region subsequently,which cause some damage to nerve function.The inflammatory response is more severe,ultimately the state of an illness is also more serious,the nerve function is more serious damaged,and the relationship between them is enhanced each other. |
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