• ROZAN ATTILI College of Pharmacy and Medical Sciences, Hebron University, P. O. Box 40; Hebron-Palestine.
  • HATEM A HEJAZ College of Pharmacy and Medical Sciences, Hebron University, P. O. Box 40; Hebron-Palestine.
  • GHALEB BOUTI College of Pharmacy and Medical Sciences, Hebron University, P. O. Box 40; Hebron-Palestine.
  • ZAHRA ABU FARA College of Pharmacy and Medical Sciences, Hebron University, P. O. Box 40; Hebron-Palestine.
  • HADEEL ALLAN College of Pharmacy and Medical Sciences, Hebron University, P. O. Box 40; Hebron-Palestine.
  • MARWA TAMIMI College of Pharmacy and Medical Sciences, Hebron University, P. O. Box 40; Hebron-Palestine.



Lymphocyte-to-monocyte ratio, Acute ischemic stroke, Stroke severity, Prognosis, Neutrophil to monocyte


Objectives: The values of white blood cell types were evaluated to determine which one is the most potential index in the diagnosis of patients with ischemic stroke (IS). Besides, neutrophil-lymphocyte ratio, neutrophil-to-monocyte ratio, and lymphocyte-to-monocyte ratio (LMR) were determined to confirm whether there is a relationship between these parameters and stroke.

Methods: One thousand files of patients admitted between January 2017 and March 2020 to intensive care units at Alia Governmental Hospital in Hebron-Palestine were reviewed and evaluated. Only a total of 87 patients were found to meet our inclusion criteria and included in the study and a total of 913 patients were excluded. Besides, complete blood counts of a total of 95 patients’ data were also collected randomly from Private Lab in Hebron district, and were considered as healthy individuals (HI); that is, a control group. The data were introduced to the excel program 2010 version to facilitate reading and analysis. GraphPad Prism version (8.3.4.) was used to analyze the data. The data of patients and HI were compared to determine which value/s of these blood components is associated with the risk of stroke.

Results: Different types of white blood cells; monocytes, lymphocytes, and neutrophils for stroke and healthy patients were collected and compared. Besides, the platelet count was also compared. It was found a marked significant decrease in the monocytes counts in all stroke patients (100–1500 cell/ul) compare to monocytes counts in the healthy donors (310–1740 cell/ul). Lymphocytes were also significantly decreased among all stroke patients (300–8600 cells/ul) compare to HI (910–9000 cells/ul). There was no significant increase in neutrophils in stroke patients. The ratios of neutrophils to monocytes and neutrophils to lymphocytes in stroke patients were compared too. The results showed a significantly elevated neutrophil ratio compare to monocytes and lymphocytes in all stroke patients. The platelet counts in stroke patients were also found less compared to HI. The percentages of these blood components were also evaluated.

Conclusion: It is demonstrated that patients with stroke have lower lymphocyte and higher monocyte counts, and therefore, lower LMR values compared to the control group. It was found that MLR was significantly correlated with IS. LMR is associated with functional outcomes in patients with stroke.


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