The Correlation Between Human Peripheral Blood Mononuclear Cell Cholinergic Muscarinic Receptor M5 Levels And Cerebral Vasospasm Caused By Spontaneous Subarachnoid Hemorrhage

Objective: Analyze the correlation and mechanism between human peripheral blood mononuclear cell cholinergic muscarinic receptor M5 levels and cerebral vasospasm caused by spontaneous subarachnoid hemorrhage to provide reference data for the study of cholinergic muscarinic receptor M5. Methods: 1.Experimental grouping: The research set up experimental group and control group.(1) Experimental group: 40 cases of spontaneous subarachnoid hemorrhage, all cases including 20 males,20 females,the age ranged from 20 to 78 years old, the average age was 52.3±13.15 years.(1) inclusion and exclusion criteria:1.inclusion criteria: spontaneous subarachnoid hemorrhage,treated within 24 h after the onset of SAH, not taking anticoagulant drugs in the past two weeks, no history of brain trauma in nearly three weeks,good heart and lung function, able to withstand the impact of interventional therapy, signed informed consent, enable to cooperate with the inspection and complete the follow-up.2.exclusion criteria:hyperlipidemia, history of blood diseases,recent use of hormones,immune inhibitors and blood products,with important organ dysfunction,non first onset and to exclude pregnant women and the one researchers believe is not suitable to participate in a clinical research.(2)experimental subgroups:Grouped according to the detection time at 24 hours, 96 hours,7 days, 14 days, as well as vasospasm group and non-spasm group.(3)Diagnosis: The diagnosis of subarachnoid hemorrhage is based on themedical history, symptoms, signs and brain CT and MRI results.Using CT angiography(Computed tomographic angiography,CTA),digital subtraction angiography(Digital subtraction angiography,DSA)to clarify the etiology of spontaneous subarachnoid.The diagnosis of cerebral vasospasm by TCD.(4)Interventions: calcium antagonist drugs was given routinely to relieve cerebral vasospasm, at the same time,the bleeding,expansion, pain and other support therapy was given. Interventional operation must be given in 7 days.After the interventional operation,calcium antagonist drugs and other symptomatic supportive treatment should be given.(2) Control group:25 cases of normal volunteers whose age ranged from 25 to 77 years,mean age was 51.76±15.94 years. 2.Experimental method: peripheral venous blood was obtained at the onset of 24 hours, 96 hours,1 week,2 weeks in the experimental groupand and TCD check was performed within 2 hours after the blood was obtained.Venous blood was getted in the control group after a 30 minutes' break and TCD check was performed within 2 hours after the blood was obtained. Mononuclear cells in the peripheral venous blood from the experimental group and control group were counted by light microscopy.To detect the peripheral blood Mononuclear cell Cholinergic Muscarinic receptor M5 levels with ELISA. 3.Statistical analysis:Relevant data use SPSS19.0 software package. Measurement data were expressed as mean standard ± deviation(x ± s),using t test to analyze;The correlation between M5 value and spasticity use spearman rank correlation analysis.P <0.05 was considered as a statistically significant difference. Results: 1.The experience group's M5 value of 24 hours, 96 hours,1 week,2 weeks were 8.71±4.83pg/ml ? 6.69±3.99pg/ml ?5.38±3.42pg/ml?7.88±4.94pg/ml; MCV measured by TCD of 24 hours,96 hours,1 week,2 weeks were 123.50±24.79cm/L?157.93±38.29cm/L?155.83±37.46cm/L?115.48±18.09cm/L.The control group's M5 value and MCV measured by TCD were 9.03±5.16pg/ml and78.84±11.77cm/L. Compared with the control group, there was no significant difference between the experimental group and the control group at 24 hours and 14 days after the onset of M5 receptor value(P>0.05),while compared with the control group, there was significant difference between the experimental group and the control group at 96 hours and 7 days after the onset of M5 receptor value(P<0.05).Compare96 hours' and 7 days' group with 24 hours' group, M5 receptor value decreased,MCV increased, the difference was statistically significant(P<0.05). Compare 14 days' group with 7 days' group, M5 receptor value increased,and MCV decreased too, the difference was statistically significant(P<0.05). Compare 14 days' group with 96hours' group,the difference of M5 receptor value was not statistically significant(P>0.05),and the MCV decreased, the difference was statistically significant(P<0.05). The number of cases of cerebral vasospasm in experimental group were respectively 24,28,32,19 at the onset of 24 hours,96 hours,1 week and 2 weeks. At different time points the value of M5 of spasm group were respectively 5.47±2.13pg/ml?4.47±1.92pg/ml?3.96±1.98pg/ml?4.21±1.72pg/ml,while the value of M5 of non-spasm group were respectively 13.58±3.41pg/ml ?11.89±2.30pg/ml?11.05±1.32pg/ml?11.19±4.54pg/ml. M5 values of spasm group were lower than non-spasm group,and the difference was statistically significant(P <0.05).3. The M5 value and the extent of vascular spasm was a negative correlation at each point of the experiment.Spearman coefficients were-0.892?-0.87?-0.821?-0.799, and P <0.05,a statistically significant. Conclusion:1.After SAH, peripheral blood mononuclear cell cholinergic muscarinic receptor M5 levels varies over time of onset: declining in the early stages, reaching a minimum at 96 hours and 7 days, and then rising up at 14 days. 2.The M5 levels of patients with SAH and the degree of spasticity was a negative correlation.The lower M5 levels,the more severe spasticity. 3. As one of the method,peripheral blood mononuclear cell cholinergic muscarinic receptor M5 levels may be used to detect the presence or absence of vascular cerebral vasospasm and the degree of spasticity.4. Cholinergic muscarinic receptor M5 may be involved in the inhibition of the CVS behind SAH.