Abstract: Objective To investigate the clinical value of dynamic thromboelastogram monitoring results in thrombolytic therapy for acute ischemic stroke. Methods A total of 70 patients with acute ischemic stroke who attended Emergency Department of Gaoming People’s Hospital from January 2023 to July 2024 were enrolled as subjects and were randomly divided into control group (empirical thrombolytic therapy) and study group (the dose of thrombolytic drug was adjusted based on thromboelastogram results). The two groups were compared in terms of the changes in thromboelastogram (reaction time of coagulation [R], coagulation formation time [K], blood clot formation rate [Angle], maximum amplitude [MA], the percentage decrease in amplitude 30 minutes post maximum amplitude [LY30], and coagulation comprehensive index [CI]) and prognosis after thrombolytic therapy, and the association of thromboelastogram with the middle-and long-term recurrence of stroke was analyzed. Results There were no significant differences in thromboelastogram results between the two groups before thrombolytic therapy (P >0.05), and both groups had significant changes in thromboelastogram results at 1, 6, and 12 hours after treatment (all P <0.05). The patients with a higher R, Angle or CI value tended to have a relatively poor prognosis and a higher middle-or long-term recurrence rate of vascular thrombosis (all P <0.05), and the patients with higher LY30 and MA values tended to have a good prognosis and a lower middle-or long-term recurrence rate of vascular thrombosis (all P <0.05). The Poisson correlation analysis showed that the values of R, K, Angle, and CI were positively correlated with middle-and long-term recurrence in patients with stroke (all P <0.05). Conclusion Dynamic thromboelastogram monitoring has a certain guiding value in thrombolytic therapy for patients with stroke, and thromboelastogram results have a certain value in predicting middle-and long-term recurrence in patients with stroke and can thus be used as routine monitoring indicators for such patients.

Key words: Thromboelastogram, Acute ischemia, Stroke, Thrombolytic therapy