Abstract: Objective To explore the clinical predictive value of neutrophil-lymphocyte ratio (NLR) combined with mean platelet volume (MPV) on prognosis of intravenous thrombolysis in the elderly patients with acute ischemic stroke (AIS). Methods A total of 76 elderly patients with AIS who received intravenous thrombolysis in our hospital from January 2017 to June 2020 were selected and divided into good prognosis group(≤2 points) and poor prognosis group (>2 points) according to Modified Rankin Scale (MRS). The general information and clinical data of the patients were collected, and the levels of white blood cell count (WBC), neutrophil count (N), lymphocyte count (L), NLR, platelet count-lymphocyte count ratio (PLR), platelet count (PLT), MPV, platelet distribution width (PDW), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), homocysteine (Hcy), total cholesterol (TC) and creatinine were detected and compared between the two groups. Multiple Logistic regression analysis was used to analyze the risk factors for poor prognosis. Receiver operating characteristic (ROC) curve was used to evaluate the effect of NLR combined with MPV on the prognosis of intravenous thrombolysis in the elderly patients with AIS. Results The levels of WBC, NLR, PLR, MPV and National Institute of Health Stroke Scale (NIHSS) score in the poor prognosis group were significantly higher than those in the good prognosis group (P<0.05). Multiple Logistic regression analysis showed that NLR and MPV were the independent influencing factors of poor prognosis (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of NLR combined with MPV was 0.845 (95%CI: 0.798-0.957), with a sensitivity of 88%, and a specificity of 91%. Conclusions NLR combined with MPV has a high predictive value for the prognosis of intravenous thrombolysis in the elderly patients with AIS.

Key words: mean platelet volume, acute ischemic stroke, aged, intravenous thrombolysis, prognosis, prediction value