Correlation Analysis Between The Systemic Immune-inflammatory Index And Hunt-Hess Grade In Patients With Intracranial Aneurysm

Background:Intracranial aneurysm（IA）is a pathological change of the intracranial artery which is gradual dilation due to changes caused by various reasons in the structure of the blood vessel wall.Aneurysmal subarachnoid hemorrhage（aSAH）is caused by blood flowing into the subarachnoid space after the rupture of IA.At present,the pathogenesis of IA has not been fully clarified,but most scholars believe that inflammatory response plays an important role in the occurrence and development of IA.The systemic immune-inflammation index（SII）,as a new index reflecting the inflammatory state of the body,has become a hot topic in recent years by combining neutrophils,platelets and lymphocytes,which are easy to obtain clinically.In this study,patients clinically diagnosed as IA were selected as the research objects,and the Hunt-Hess grade was used to preliminarily evaluate the condition of the aSAH patients and calculate SII.To explore whether SII is related to Hunt-Hess grading of aSAH patients,so as to further evaluate the judgment value of SII combined with Hunt-Hess grading on the clinical status of IA and the severity of aSAH.Objective:To count and calculate peripheral blood SII of IA patients and analyze the correlation between SII and Hunt-Hess grade,so as to further evaluate the judgment value of SII combined with Hunt-Hess grade on IA clinical status and severity of aSAH.Methods:Data of patients aged 18 and above diagnosed with IA in the Neurovascular Surgery Department of the First Hospital of Jilin University from January 2021 to December 2021 were collected and analyzed.According to inclusion and exclusion criteria,a total of 187 patients were enrolled for analysis.The severity of IA patients was preliminarily evaluated by Hunt-Hess grade,and patients were divided into aSAH group（n=164）and unruptured IA group（n=23）according to whether IA ruptured or not.Venous blood was collected within 2 hours after admission for the routine blood test,and the absolute values of neutrophils,lymphocytes and platelets were used to calculate SII.SPSS24.0 software was used for statistical analysis.A non-parametric test was used to analyze data differences between the two groups.Spearman correlation analysis was used to analyze the correlation between absolute values of neutrophils,lymphocytes,platelets and Hunt-Hess grade,as well as the correlation between SII and Hunt-Hess grade.Results:The analysis revealed no statistically significant difference in the clinical characteristics between the unruptured IA and aSAH groups.Comparing the absolute values of neutrophils,lymphocytes and platelets in the two groups,it was found that,compared with the unruptured IA group,the absolute values of neutrophils and platelets in the aSAH group significantly increased[3.63（3.15,4,18）×10~9/L Vs.8.50（4.80,11.08）×10~9/L,P=0.000/201.52（158.00,267.00）×10~9/L Vs.228.61（194.00,260.75）×109/L,P<0.05],while the absolute values of lymphocytes significantly decreased[2.01（1.62,2.15）×10~9/L Vs.1.47（0.85,1.91）×10~9/L,P<0.05].（r=0.581,P=0.000/r=0.170,P<0.05）.The absolute values of neutrophils and platelets were significantly positively correlated with Hunt-Hess grade（r=0.581,P=0.000/r=0.170,P<0.05）,while the absolute value of lymphocytes was significantly negatively correlated with Hunt-Hess grade（r=-0.230,P<0.05）.Compared with Hunt-Hess grade〇,both the SII of Hunt-Hess gradeⅠ-Ⅴpatients significantly increased,with statistically significant differences（P<0.05）.There was no statistical difference in SII between Hunt-Hess grade I and II（P=0.91）,but the SII of grade III-V patients was significantly higher than that of grade I patients（P<0.05）.Compared with Hunt-Hess grade II,SII was significantly higher in Hunt-Hess grade III-V（P<0.05）.SII was significantly higher in Hunt-Hess grade IV-V compared with Hunt-Hess grade III（P<0.05）,and SII was significantly higher in Hunt-Hess grade V compared with Hunt-Hess grade IV（P<0.05）.Correlation analysis of SII and Hunt-Hess grade in IA patients showed that SII was positively correlated with Hunt-Hess grade（r=0.420,P=0.000）.Conclusions:（1）Compared with the unruptured IA group,SII in the aSAH group significantly increased,suggesting that SII might be significantly correlated with the clinical status of IA.（2）Absolute values of neutrophils and platelets were positively correlated with Hunt-Hess grade in IA patients,while the absolute value of lymphocytes was negatively correlated with Hunt-Hess grading in IA patients,suggesting that the absolute values of neutrophils,platelets and lymphocytes might be used to predict the severity of IA patients.（3）A positive correlation was found between SII and Hunt-Hess grade in IA patients,and the use of Hunt-Hess grade in combination with SII may be more accurate in assessing the condition of IA patients.