Relationship between serum HDAC4 and MYD88 levels and hemorrhagic transformation after intravenous thrombolysis with rt-PA in acute cerebral infarction
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3969/j.issn.1673-4130.2024.11.007
   		
        
        	
        		- VernacularTitle:血清HDAC4和MYD88水平与急性脑梗死rt-PA静脉溶栓后出血转化的关系研究
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Changjia LIU
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Jie HAO
			        		
			        		;
		        		
		        		
		        		
			        		Minxiao LIU
			        		
			        		;
		        		
		        		
		        		
			        		Yin LI
			        		
			        		;
		        		
		        		
		        		
			        		Jinsong TANG
			        		
			        		;
		        		
		        		
		        		
			        		Fan LI
			        		
			        		;
		        		
		        		
		        		
			        		Xin LI
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 河北北方学院附属第二医院神经内科,河北张家口 075100
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		histone deacetylase 4;
			        		
			        		
			        		
				        		myeloid differentiation protein 88;
			        		
			        		
			        		
				        		acute cerebral infarction;
			        		
			        		
			        		
				        		intra-venous thrombolysis;
			        		
			        		
			        		
				        		hemorrhagic transformation
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			International Journal of Laboratory Medicine
	            		
	            		 2024;45(11):1313-1317
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	Objective To investigate the relationship between serum histone deacetylase 4(HDAC4)and myeloid differentiation protein 88(MYD88)levels and hemorrhagic transformation after intravenous throm-bolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction(ACI).Methods A total of 169 patients with ACI who were treated with rt-PA intravenous thrombolysis in this hospital from May 2020 to May 2022 were selected as the research objects,and they were divided into transformation group(46 cases)and non-transformation group(123 cases)according to whether hemorrhagic transformation occurred after rt-PA intravenous thrombolysis.In addition,156 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the serum levels of HDAC4 and MYD88 in each group,and the gen-eral data of transformation group and non-transformation group were compared.Pearson correlation was used to analyze the correlation between serum HDAC4 and MYD88 levels in ACI patients.Multivariate Logistic re-gression analysis was used to analyze the related factors of hemorrhagic transformation in ACI patients after intravenous thrombolysis with rt-PA.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of HDAC4,MYD88 levels and their combination for hemorrhagic transformation in ACI patients after rt-PA intravenous thrombolysis.Results The serum level of HDAC4 in ACI group was signifi-cantly lower than that in control group,and the serum level of MYD88 in ACI group was significantly higher than that in control group(P<0.05).There were no significant differences in gender,age,body mass index,fasting blood glucose,hyperlipidemia,and coronary heart disease between the non-transformation group and the transformation group(P>0.05),while there were significant differences in atrial fibrillation,National In-stitute of Health Stroke Scale(NIHSS)score,and the time from onset to thrombolysis between the two groups(P<0.05).The level of serum HDAC4 in transformation group was lower than that in non-transfor-mation group,and the level of serum MYD88 in transformation group was higher than that in non-transforma-tion group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that serum HDAC4 level was negatively correlated with MYD88 in ACI patients(r=-0.401,P<0.001).Multi-variate Logistic regression analysis showed that atrial fibrillation,time from onset to thrombolysis,NIHSS score and MYD88 level were the risk factors for hemorrhagic transformation in ACI patients after rt-PA intra-venous thrombolysis,HDAC4 level was a protective factor for hemorrhagic transformation in ACI patients af-ter intravenous thrombolysis with rt-PA(P<0.05).The area under the curve(AUC)of combined HDAC4 and MYD88 was 0.876,and the sensitivity and specificity were 65.22%and 98.37%,respectively,which was better than that of HDAC4 and MYD88 alone(Zcombined-HDAC4=2.298,P=0.022;Zcombined-MYD88=2.5 4 5,P=0.011).Conclusion The serum levels of HDAC4 and MYD88 in ACI patients are closely related to hemor-rhagic transformation after intravenous thrombolysis with rt-PA.