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已发表论文
改良综合免疫炎症指标对缺血性脑卒中溶栓患者出血性转化的预测价值：一项回顾性研究
Authors Cai J, Rao H, Li X, Luo J, Wang Z, Liu D
Received 9 June 2025
Accepted for publication 1 October 2025
Published 21 October 2025 Volume 2025:18 Pages 6353—6363
DOI https://doi.org/10.2147/IJGM.S545665
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Junzhi Cai,1 Hui Rao,2 Xiangyang Li,1 Jingwen Luo,1 Zhenchang Wang,1 Dezhong Liu1
1Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 2Department of Laboratory Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
Correspondence: Dezhong Liu, Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email liudez2005@163.com
Objective: Ischemic stroke is closely related to inflammation and immune balance. The purpose of this study was to investigate the relationship of modified comprehensive immunoinflammatory indices (modified pan-immune-inflammation-value (mPIV), modified systemic immune-inflammatory index (mSII), modified systemic inflammatory response index (mSIRI)) and hemorrhagic transformation (HT) of ischemic stroke.
Methods: 894 ischemic stroke patients treated in Meizhou People’s Hospital from January 2019 to May 2024 were retrospectively analyzed. Clinical characteristics were collected, and mPIV, mSII, and mSIRI were calculated. The optimal cutoff values of mPIV, mSII, and mSIRI were analyzed by receiver operating characteristic (ROC) curve analysis. The relationship between mPIV, mSII, mSIRI and HT of ischemic stroke was analyzed.
Results: There were 685 (76.6%) patients without HT and 209 (23.4%) with HT. The cases with HT had higher mPIV (1337.71 (698.79, 2511.19) vs 992.37 (599.30, 1884.53), p=0.001), mSII (3418.31 (1895.87, 7112.89) vs 2574.81 (1630.46, 4006.18), p< 0.001), and mSIRI level (963.60 (517.86, 1947.87) vs 698.75 (446.99, 1100.62), p< 0.001) than those without HT. In ROC analysis, the cutoff value of mPIV was 1302.4 (sensitivity 50.7%, specificity 64.7%, area under the ROC curve (AUC): 0.575), mSII cutoff value was 3186.5 (sensitivity 54.5%, specificity 63.8%, AUC: 0.605), and mSIRI cutoff value was 996.5 (sensitivity 49.8%, specificity 70.2%, AUC: 0.610). Logistic regression analysis showed that high mPIV (odds ratio (OR): 1.901, 95% confidence interval (CI): 1.381– 2.617, p< 0.001), high mSII (OR: 2.081, 95% CI: 1.517– 2.854, p< 0.001), and high mSIRI (OR: 2.290, 95% CI: 1.664– 3.151, p< 0.001) were significantly associated with HT.
Conclusion: High levels of mPIV, mSII, and mSIRI may be associated with hemorrhagic transformationin patients with ischemic stroke who received intravenous thrombolysis treatment.
Keywords: ischemic stroke, hemorrhagic transformation, modified pan-immune-inflammation-value, modified systemic immune-inflammatory index, modified systemic inflammatory response index
1Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 2Department of Laboratory Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
Correspondence: Dezhong Liu, Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email liudez2005@163.com
Objective: Ischemic stroke is closely related to inflammation and immune balance. The purpose of this study was to investigate the relationship of modified comprehensive immunoinflammatory indices (modified pan-immune-inflammation-value (mPIV), modified systemic immune-inflammatory index (mSII), modified systemic inflammatory response index (mSIRI)) and hemorrhagic transformation (HT) of ischemic stroke.
Methods: 894 ischemic stroke patients treated in Meizhou People’s Hospital from January 2019 to May 2024 were retrospectively analyzed. Clinical characteristics were collected, and mPIV, mSII, and mSIRI were calculated. The optimal cutoff values of mPIV, mSII, and mSIRI were analyzed by receiver operating characteristic (ROC) curve analysis. The relationship between mPIV, mSII, mSIRI and HT of ischemic stroke was analyzed.
Results: There were 685 (76.6%) patients without HT and 209 (23.4%) with HT. The cases with HT had higher mPIV (1337.71 (698.79, 2511.19) vs 992.37 (599.30, 1884.53), p=0.001), mSII (3418.31 (1895.87, 7112.89) vs 2574.81 (1630.46, 4006.18), p< 0.001), and mSIRI level (963.60 (517.86, 1947.87) vs 698.75 (446.99, 1100.62), p< 0.001) than those without HT. In ROC analysis, the cutoff value of mPIV was 1302.4 (sensitivity 50.7%, specificity 64.7%, area under the ROC curve (AUC): 0.575), mSII cutoff value was 3186.5 (sensitivity 54.5%, specificity 63.8%, AUC: 0.605), and mSIRI cutoff value was 996.5 (sensitivity 49.8%, specificity 70.2%, AUC: 0.610). Logistic regression analysis showed that high mPIV (odds ratio (OR): 1.901, 95% confidence interval (CI): 1.381– 2.617, p< 0.001), high mSII (OR: 2.081, 95% CI: 1.517– 2.854, p< 0.001), and high mSIRI (OR: 2.290, 95% CI: 1.664– 3.151, p< 0.001) were significantly associated with HT.
Conclusion: High levels of mPIV, mSII, and mSIRI may be associated with hemorrhagic transformationin patients with ischemic stroke who received intravenous thrombolysis treatment.
Keywords: ischemic stroke, hemorrhagic transformation, modified pan-immune-inflammation-value, modified systemic immune-inflammatory index, modified systemic inflammatory response index