Evaluation Value of Thromboelastography Combined with Systemic Immunoinflammatory Index in Hemorrhagic Transformation after Acute Cerebral Infarction

GUO Gang; SHI Yi

doi:10.3639/i.issn.2095-3097.2025.01.032

Abstract：Objective To explore the value of thromboelastography(TEG)combined with systemic immunoinflammatory index(SII)in the evaluation of hemorrhagic transformation(HT)after acute cerebral infarction.Methods A total of 120 cases with acute cerebral infarction admitted in the Yan'an University Affiliated Hospital from January 2021 to May 2024 were selected,and they were divided into the HT group and non-HT group according to the imaging findings 72 hours after admission.All patients were examined by TEG,and SII(SII=product of neutrophil count and platelet count/lymphocyte count)was calculated within 24 hours after admission.The clinical data of all patients were collected,and the clinical value of TEG parameters and SII in evaluating HT after acute cerebral infarction was evaluated by the receiver operating characteristic(ROC)curve.The influencing factors for HT after acute cerebral infarction were investigated by multivariate Logistic stepwise regression analysis.Results A total of 120 patients with acute cerebral infarction were selected as the research subjects,of whom 26(21.67%)cases experienced HT.There were no significant differences in clot kinetics(K),α angle(speed of fibrin build-up)and maximum amplitude(MA)between groups(P>0.05).The reaction time(R),LY30(percentage of clot lysis 30 minutes after the maximum clot strength is reached)and SII in the HT group were significantly higher than those in non-HT group(P<0.05).The area under the curve(AUC)and their corresponding 95%confidence interval(CI)of TEG parameters R,LY30,SII,and their combined evaluation of HT after acute cerebral infarction was 0.754(0.709-0.799),0.802(0.757-0.847),0.869(0.824-0.916),and 0.917(0.867-0.962),respectively.There were no significantly differences in the age,gender,underlying diseases,body mass index(BMI),alcohol consumption history and cerebral infarction site between the two groups(P>0.05).The smoking history,large cerebral infarction,anticoagulant therapy,double antiplatelet ratio and the National Institutes of Health Stroke Scale(NIHSS)score in the HT group were significantly higher than those of non-HT group(P<0.05).Logistic regression analysis showed that the large-scale cerebral infarction(OR=2.143,95%CI:1.292-3.553),anticoagulation therapy(OR=2.020,95%CI:1.185-3.442),R≥5.67(OR=2.509,95%CI:1.391-4.527),LY30≥2.18(OR=2.707,95%CI:1.510-4.855),and SII≥1088.67(OR=4.614,95%CI:2.078-10.244)were independent risk factors affecting HT after acute cerebral infarction(P<0.05).Conclusion TEG parameters combined with SII has a high value in the evaluation of HT after acute cerebral infarction,and can be used as a potential biomarker for the evaluation of HT after acute cerebral infarction.