The Relationship Between Thrombelastography Dynamic Monitoring and PAgT, LPa and Its Value in Assessing the Prognosis of Patients with Acute Cerebral Infarction

doi:10.3969/j.issn.1004-5775.2025.10.002

Abstract：Objective: To explore the relationship between thrombelastography dynamic monitoring and platelet aggregation rate (PAgT) and lipoprotein(a) (LPa), and to assess the value of these indicators in predicting the prognosis of patients with acute cerebral infarction. Methods: A total of 96 patients with acute cerebral infarction admitted to Nanyang Second People's Hospital from October 2021 to October 2023 were selected as the study subjects. The patients were divided into two groups based on the recurrence of cerebral infarction: the poor prognosis group (36 cases) and the good prognosis group (60 cases). The levels of thrombelastography indicators, PAgT, and LPa were detected and compared between the two groups. Software was used for statistical analysis to evaluate the relationship between thrombelastography dynamic monitoring indicators and PAgT, LPa. High-risk factors for poor prognosis in patients with acute cerebral infarction were screened, and the receiver operating characteristic (ROC) curve was used to evaluate the clinical value of thrombelastography parameters in predicting the prognosis of patients with acute cerebral infarction. Results: The levels of coagulation factor reaction time (R) and clot formation time (K) were higher in the good prognosis group than in the poor prognosis group, while the α angle and maximum amplitude (MA) were lower in the good prognosis group, with statistically significant differences (t=14.702, 7.301, 6.500, 3855, P<0.001). The levels of PAgT and LPa were lower in the good prognosis group than in the poor prognosis group, with statistically significant differences (t=4.960, 18.522, P<0.001). There was a negative correlation between thrombelastography indicators R and K and PAgT and LPa levels, while the α angle and MA showed a positive correlation with PAgT and LPa levels. Screening of high-risk factors for poor prognosis in patients with acute cerebral infarction showed that R, K, α angle, MA, PAgT, and LPa were high-risk factors for poor prognosis (OR=6.348, 2.142, 5.963, 6.057, 5.421, 3.466, P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) for thrombelastography parameters in assessing the prognosis of patients with acute cerebral infarction were 0.641, 0.754, 0.825, and 0.952, respectively. Conclusion: Thrombelastography monitoring can evaluate the function of the coagulation-fibrinolytic system and platelet aggregation rate in patients with acute cerebral infarction. Thrombelastography parameters are closely related to LPa levels and can predict poor prognosis.