To analyze the difference of d-dimer and neutrophil-lymphocyte ratio (NLR) in peripheral blood of patients with different TOAST types of acute cerebral infarction (ACI), and to explore its clinical significance in the rapid diagnosis and condition assessment of ACI.

A retrospective case-control study was conducted on 224 patients (ACI group) admitted to the Emergency Medical Center of the First Affiliated Hospital of Nanjing Medical University from March 2018 to March 2019 and 178 healthy people (control group) who underwent physical examination in the Health Management Center of the First Affiliated Hospital of Nanjing Medical University during the same period. ACI patients were subjected to skull computer tomography angiography (CTA) and digital subtraction angiography (DSA) to demonstrate vascular lesions, and to determine the TOAST classification [artery atherosclerosis model (LAA), small artery occlusion model (SAO), cardiac embolism (CE), other type clear etiology (SOD) and unknown causes (SUE)]. The differences of d-dimer and neutrophil-lymphocyte ratio (NLR) in peripheral blood between ACI group and control group and TOAST subtypes were compared to analyze the relationship between d-dime and NLR and TOAST type in acute cerebral infarction.

The levels of d-dimer [(1.321±0.690) mg/L vs. (0.050±0.021) mg/L] and NLR [(4.515±1.693) vs. (1.722±0.674)] in peripheral blood of patients in the ACI group were significantly higher than those in the control group. This research into the type of ACI patients included LAA (83 cases), SAO (76 cases) and CE (65 cases), type of CE in patients with d-dimer [(2.858±1.639 mg/L)] and NLR (8.128 + 2.069), the highest level and LAA type [(1.317 ±0.172)mg/L, (4.323±1.776)] that were higher than SAO type [(0.655±0.672 mg/L), (2.210±1.690)], the differences were statistically significant (P<0.05). In addition, the level of d-dimer in peripheral blood of ACI patients was positively correlated with NLR [r=0.604, 95% confidence interval (CI) : 0.644~8.475, P < 0.05].

There are differences in d-dimer and NLR levels in peripheral blood of ACI patients with different TOAST typing, and monitoring their level changes is helpful for clinical early typing and diagnosis.