Objective To investigate the prognostic value of the Alberta stroke program early CT(ASPECT) score combined with neutrophil/lymphocyte ratio(NLR) in the prediction of mechanical thrombolysis in acute large vessel occlusive ischemic stroke(AIS-LVO).

Methods The clinical data of 84 AIS-LVO patients treated with mechanical thrombolysis were retrospectively analyzed, and the patients were divided into the good prognosis group(n=32) and poor prognosis group(n=52) according to the 90-day mRS score.The basic clinical, imaging, and laboratory data were compared between two groups.To analyze the association of preoperative ASPECT score and postoperative NLR with poor prognosis at 90-day postperatively in patients with mechanical thrombolysis and its value in predicting poor prognosis.

Results The posterior circulation occlusion, preoperative NIHSS score, postoperative NLR and symptomatic intracranial hemorrhage in the poor prognosis group were higher than those in good prognosis group, and the preoperative ASPECT score was lower than that in good prognosis group(P < 0.05 to P < 0.01).The results of multifactorial logistic regression analysis showed that the low preoperative ASPECT score, high postoperative NLR and symptomatic intracranial hemorrhage were the independent risk factors affecting patients' prognosis(P < 0.05 to P < 0.01).The AUC of postoperative NLR combined with ASPECT score to predict poor prognosis after thrombectomy in AIS-LVO patients was 0.913, which was higher than the results predicted by ASPECT score and postoperative NLR alone(AUC of 0.768 and 0.888, respectively, P < 0.05).

Conclusions Decreasing the preoperative ASPECT score, increasing postoperative NLR and symptomatic intracranial hemorrhage are associated with the poor prognosis of mechanical thrombolysis in patients with AIS-LVO, and the preoperative ASPECT score combined with postoperative NLR can better predict the occurrence of poor prognosis.