Abstract: Objective　To investigate the predictive value of peripheral blood mean platelet volume and lymphocyte ratio (MPVLR) in the prognosis of acute ischemic stroke (AIS) patients treated with recombinant tissue plasminogen activator (rtPA) intravenous thrombolysis. Methods　 A total of 341 patients with AIS were collected. According to the modified Rankin scale (mRS) at 90 days after the onset of AIS, patients were divided into good prognosis group (mRS＜3, n=198) and poor prognosis group (mRS≥3, n=143). The baseline data and laboratory test results were collected in the two groups of patients. The multivariate Logistic regression was used to analyze the factors affecting the poor prognosis of patients. The receiver operating characteristic (ROC) curve was draw to judge and evaluate the prediction threshold of lymphocyte, platelet count (PLT), MPV, MPVLR and PLR for the poor prognosis of AIS patients. Results　(1) The age, NIHSS score，MPV，MPVLR，platelet to lymphocyte ratio (PLR) were significantly higher in the poor prognosis group than those of the good prognosis group (P＜0.05). Data of the lymphocyte count and PLT were significantly lower in the poor prognosis group than those of the good prognosis group (P＜0.05). Multivariate Logistic regression analysis showed that age (OR=1.026, 95%CI: 1.004-1.049), the admission NIHSS score (OR=1.112, 95%CI: 1.057-1.170), MPVLR (OR=3.415, 95%CI: 2.187-5.332) were the independent risk factors for the prognosis of AIS patients at 90 days. (2) ROC analysis showed that MPVLR (0.776) was better for predicting the poor prognosis of AIS than lymphocyte count (0.676), PLT (0.646), MPV (0.659) and PLR (0.703). The best prediction cutoff value of MPVLR was 6.5. With 6.5 as the cutoff value. The age, admission NIHSS score, MPV and PLR were higher in the high MPVLR group (≥6.5, n=174) than those in the low MPVLR group (<6.5, n=167), and the counts of lymphocytes and PLT were lower in high MPVLR group than those of the low MPVLR group (P＜0.05). Conclusion　Peripheral MPVLR might be used as an effective predictor of prognosis in AIS patients treated with rtPA intravenous thrombolysis, which is helpful for risk stratification and individual treatment.

Key words: stroke, thrombolytic therapy, plasminogen activators, prognosis, mean platelet volume, lymphocytes, modified Rankin scale, mean platelet volume to lymphocyte ratio