| ObjectiveThis study was designed to detect the serum level of the intestinal microflora metabolites--trimethylamine oxide(TMAO)in the peripheral blood of the patients with acute intracerebral hemorrhage(ICH),and to investigate the correlation between the level of TMAO in the peripheral blood,and the degree of brain damage/prognosis of the patients with acute ICH.The object of our study is to evaluate the influence of ICH on the serum level of TMAO in the acute phase of ICH,and the relationship between the serum level of TMAO and outcome of patients on day 90 after ICH in patients.MethodsA total of 87 consecutive patients with acute ICH underwent minimally invasive evacuation surgery(MIS)of hematoma in the Fifth Affiliated Hospital of Zhengzhou University and the people's Hospital of Gongyi city were enrolled as the study group from May 1,2016,to May 31,2017.One hundred age-matched healthy controls were also recruited.All of the control subjects came from the health checkup center of the Fifth Affiliated Hospital of Zhengzhou University.Peripheral blood samples(5 mL)were collected once from ICH patients before the surgery.Peripheral blood samples(5 mL)were drawn from control subjects on the day after they signed the consent.We detected the serum level of TMAO by the Ultra-performance liquid Chromatography-electrospray tandem Mass Spectrometry technology(UPLC-MS/MS).Lesion volume,Glasgow Coma Scale(GCS)and National Institutes of Health Stroke Scale(NIHSS)on admission,and time from the onset to the surgery were recorded.Modified Rankin Scale(mRS)score were also recorded on day 90 after ICH.The difference in the serum level of TMAO was compared between patients with acute ICH and healthy controls.And the relationship between TMAO level and the degree of brain damage/prognosis of patients with acute ICH will also be evaluated in this study.Results1.Changes in the serum level of TMAO in patients with acute ICH and correlation analysisThe serum level of TMAO was significantly lower in patients with acute ICH than that of the normal control group(Z=2.654,p=0.037).The serum level of TMAO positively correlated with age(r=0.324,p=0.001),the lesion volume(r=0.102,p=0.047),the NIHSS score(r=0.186,p=0.042)on admission,and mRS score(r=0.209,p=0.026)on day 90 after onset,but negatively correlated with GCS score(r=0.402,p=0.000)on admission.2.The correlation between the serum level of TMAO on admission and neurological outcome on day 90 after acute ICH.The serum level of TMAO(117.25±15.78 VS 158.71±25.45,t=9.365,p<0.001),lesion volume(47.67±40.62 VS 73.46±34.72,t=2.983,p=0.001),the ratio for combined with ventricular hemorrhage(13 VS 36,?~2=4.052,p=0.044),the GCS score(11.67±2.78 VS 6.31±2.81,t=8.553,p<0.001),and NIHSS score(12.67±2.18VS 24.27±5.33,t=14.27,p<0.001)on admission and time from the onset to surgery(9.82±7.09 VS 19.01±7.06,t=5.799,p<0.001)were significantly different in patients with good outcome(mRS?3)and poor outcome(mRS>3)(p<0.05).Logistic regression analysis revealed that relatively high serum level of TMAO(OR=1.569,p=0.027)and more lesion volume(OR=3.135,p=0.016)were the independent risk factors for neurological outcome on day 90 after ICH.Conclusions1.The serum level of TMAO was significantly lower in patients with acute ICH than that of the normal control group,and serum level of TMAO may correlate with the age of patients,the NIHSS score and GCS score at the admission,the mRS score on day 90 after ICH.2.The serum level of TMAO,lesion volume,the ratio for combined with ventricular hemorrhage,the GCS score and NIHSS score on admission and time from the onset to surgery affected the neurological outcome on day 90 after ICH.Logistic regression analysis revealed that relatively low serum level of TMAO and less lesion volume were the independent factors for neurological outcome on day 90 after ICH. |
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