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Objective To discuss the relationship between serum lipoprotein-associated phospholipase A2 (LpPLA2), low-density lipoprotein (LDL), amyloid beta 1-42 (Aβ1-42) and soluble intercellular adhesion molecule-1 (sICAM-1) levels, the National Institutes of Health Stroke Scale (NIHSS) score and prognosis in patients with acute ischemic stroke (AIS). Methods A total of 106 patients with AIS who underwent intravenous thrombolysis (the thrombolysis group), 30 AIS patients without thrombolysis (the non-thrombolysis group) and 95 healthy individuals (the control group) were included in the study. The thrombolysis group was divided into the recanalization group (n=41) and the non-recanalization group (n=65) according to whether the vein was recanalized after thrombolysis. Patients were divided into the mild group (n=45), the moderate group (n=36) and the severe group (n=25) based on the NIHSS score. They were divided into the good prognosis group (n=65) and the poor prognosis group (n=41) based on the modified Rankin Scale (mRS) score. Serum levels of four indexes in different groups were compared. Their relationship with the NIHSS score and the prognosis was analyzed. Results The vein recanalization rate in 106 patients with thrombolysis was 38.68% (41/106). Serum Lp-PLA2, LDL, Aβ1-42 and sICAM-1 levels were lower in the recanalization group than those in the non-canalization group (P＜0.05). Serum LpPLA2, LDL, Aβ1-42 and sICAM-1 levels increased successively in the control group, the thrombolysis group and the nonthrombolysis group (P＜0.05). The 4 serum indexes increased with the aggravation of disease condition, and were positively correlated with NIHSS score (P＜0.05). High serum levels of Lp-PLA2, LDL, Aβ1-42 and sICAM-1 were risk factors for poor prognosis of patients with thrombolysis (P＜0.05). The area under the curve (AUC) and specificity of the combination of 4 serum indexes for predicting poor prognosis of patients with thrombolysis were higher than those of prediction with single index (P＜0.05). Conclusion The expression levels of serum Lp-PLA2, LDL, Aβ1-42 and sICAM-1 in patients with AIS are high. They can be used as important reference indexes for disease condition monitoring and prognosis evaluation. [ABSTRACT FROM AUTHOR]