Evaluation of Coagulation Function in Patients with Intracranial Aneurysms and Its Predictive Value for Clinical Outcome

YUAN Zihan; LI Junying; XU Yingkai; LIU Lei

doi:10.13730/j.issn.2097-2148.2025.12.004

Abstract：Objective To evaluate the coagulation function of patients with intracranial aneurysm by varieties of de-tection methods,analyze whether the change of coagulation function was associated with the rupture of intracranial aneu-rysm and its clinical predictive value.Methods A retrospective analysis was conducted on the clinical data of 217 patients with intracranial aneurysms who were first diagnosed in the author's hospital from January 2014 to December 2023,the patients were divided into unruptured group(n=64)and ruptured group(n=153)according to the presence or absence of intracranial aneurysm rupture.The coagulation function of patients with intracranial aneurysms was analyzed through traditional coagulation function tests,throm-boelastography(TEG)monitoring and assessment of platelet activation degree,Logistic regression was used to analyze the risk factors for intracranial aneurysm rupture,the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of coagulation function indica-tors for intracranial aneurysm rupture,Spearman correlation analysis was adopted to explore the correlation between tra-ditional coagulation function test indicators and TEG parameters.Results The coagulation function of patients in the two groups were within the normal range.The prothrombin time(PT)and fibrinogen(FIB)in the rupture group were signifi-cantly higher than those in the unrupture group(P＜0.05),while the activated partial thromboplastin time(APTT)and coagulation reaction time(R value)were significantly lower than those in the unrupture group(P＜0.05);the platelet activation degrees of patients in the two groups were within the normal range.The positive rate of platelet activator com-bined-1(PAC-1)activated by adenosine diphosphate(ADP)in rupture group was significantly lower than that in unrup-ture group(P＜0.05);Logistic regression analysis showed that history of hypertension,PT and APTT were independent influencing factors for rupture in patients with intracranial aneurysms(P＜0.05).The results of ROC curve analysis showed that the areas under the curve for the diagnosis of rupture in patients with intracranial aneurysms by PT,APTT and their combined detection were 0.681,0.813 and 0.857,respectively.Correlation analysis showed that the R value was positively correlated with APTT(r=0.292,P＜0.001);FIB was negatively correlated with the coagulation forma-tion time(K value)(r=-0.313,P＜0.001),positively correlated with the coagulation angle(Angle value)(r=0.324,P＜0.001)and positively correlated with the maximum amplitude(MA)of thrombus(r=0.413,P＜0.001);platelet count(PLT)was negatively correlated with K value(r=-0.377,P＜0.001),positively correlated with Angle value(r=0.340,P＜0.001),and positively correlated with MA value(r=0.450,P＜0.001).Conclusion The traditional co-agulation function test combined with thromboelastography is helpful to evaluate the coagulation function of patients with intracranial aneurysm more comprehensively,and some indicators of the traditional coagulation function test have good di-agnostic value for the diagnosis of intracranial aneurysm rupture.