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To investigate the relationship between mean platelet volume (MPV) level and carotid atherosclerosis and prognosis in patients with acute cerebral infarction . A retrospectively included 160 patients with acute cerebral infarction classified by TOAST classification as aortic atherosclerosis as the observation group. To analyze the relationship between MPV and carotid atherosclerosis, and use receiver operating characteristic (ROC) curves to analyze the role of MPV in predicting the prognosis of acute cerebral infarction in