Objective  To investigate the effect of recombinant tissue plasminogen activator(rt-PA) on neutrophil-to-lymphocyte ratio (NLR) within 24 h on 90 d prognosis in patients with acute ischemic stroke (AIS) after intravenous thrombolytic therapy by rt-PA.

  Methods  The clinical data of patients with AIS treated by intravenous thrombolytic therapy with rt-PA was retrospectively analyzed. The modified Rankin Scale (mRS) score and death condition at 90 d were used as the curative effect index. The patients were divided into good prognosis group (mRS score≤2) and poor prognosis group (mRS score>2 and the death). Multivariate Logistic regression analysis was used to investigate the independent risk factors for prognosis after thrombolysis, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NLR level after thrombolysis for the prognosis of patients with AIS.

  Results  The multivariate Logistic regression analysis showed that NIHSS score before thrombolytic therapy and NLR after thrombolytic therapy were both independent risk factors for poor prognosis. After thrombolytic therapy, the diagnostic threshold value of NLR for poor prognosis of AIS patients was 0.769, the sensitivity was 80.00% and the specificity was 73.80%.

  Conclusion  The level of NLR within 24 h after thrombolytic therapy is a good index to predict the prognosis of patients with AIS thrombolytic therapy.