Evaluation value of thrombelastogram combined with S100-β and D-dimer in prognosis and recurrence of acute cerebral infarction

Zhang Feng; Wang Ruixue; Li Jinchao

doi:10.3969/j.issn.1674-7151.2024.02.007

Abstract：Objective To explore the evaluation value of thrombelastogram combined with central nervous specific protein(S100-β)and D-dimer in prognosis and recurrence of acute cerebral infarction(ACI).Methods The clinical data of 180 ACI patients admitted to Jinan Integrated Traditional Chinese and Western Medicine Hospital from July 2020 to July 2022 were reviewed and analyzed.After one month of treatment,the patients were classified by Glasgow outcome scale(GOS)and all patients were divided into good prognosis group(GOS score of 4-5 points;65 cases)and poor prognosis group(GOS score of 1-3 points;115 cases).The patients were divided into recurrence group(42 cases)and non recurrence group(138 cases)based on whether they experienced recurrence within one year.The levels of thrombelastogram parameters[including reaction time(RT),Kaolin time(KT),coagulation angle(α angle)and maximum amplitude(MA)],S100-β and D-dimer were measured,and the differences of above indicators among different groups were compared.The correlation of thrombelastogram prameters,S100-β,D-dimer and GOS score was analyzed using Spearman correlation analysis.After one-year follow up,the receiver operator characteristic(ROC)curve was drawn,the area under ROC curve(AUC)was calculated,and the predictive value of changes in parameters for recurrence in ACI patients were analyzed.Results The levels of RT and KT in good prognosis group were higher than those in poor prognosis group,and the levels of α angle,MA,S100-β and D-dimer were lower than those in poor prognosis group[RT(min):5.19±1.21 vs.4.37±0.82;KT(min):1.85±0.37 vs.1.56±0.24;α angle(°):60.76±7.12 vs.68.49±8.09;MA(mm):61.34±5.86 vs.67.05±6.39;S100-β(mg/L):16.78±2.63 vs.19.37±3.51;D-dimer(mg/L):1.69±0.45 vs.2.31±0.68;all P<0.001].Correlation analysis showed that α angle and MA were negatively correlated with GOS score(r values were-0.394 and-0.352,both P<0.001),and RT,KT,S100-β and D-dimer were positively correlated with GOS score(r values were 0.314,0.388,0.407 and 0.415,all P<0.001).The levels of RT and KT in non recurrent group were higher than those in recurrent group,and the levels of α angle,MA,S100-β and D-dimer were lower than those in recurrent group[RT(min):6.52±1.26 vs.5.52±1.37;KT(min):2.25±0.63 vs.1.66±0.54;α angle(°):56.83±5.44 vs.60.74±6.91;MA(mm):58.27±6.15 vs.63.34±7.55;S100-β(mg/L):14.35±2.32 vs.16.03±2.61;D-dimer(mg/L):0.98±0.29 vs.1.22±0.37;all P<0.001].ROC curve analysis showed that the AUC of KT,MA,RT,α angle,S100-β and D-dimer for predicting ACI recurrence were 0.774,0.638,0.671,0.703,0.833 and 0.749,respectively.Conclusion The levels of thromboelastography parameters,S100-β and D-dimer are closely related to the progression of ACI patients and have certain predictive value for recurrence of ACI.