【Abstract】Objective To investigate the correlation between serum soluble CD40 ligand (sCD40L), CD146 and prognosis of patients with regional blood perfusion after cerebral ischemic stroke (CIS). Methods 102 patients with CIS admitted to the hospital between January 2017 and December 2019 were selected as subjects. They were divided into the hypoperfusion group (regional hypoperfusion) and the control group (regional blood flow no perfusion) according to the imaging examination results. Patients in the hypoperfusion group were divided into the good prognosis group and the poor prognosis group according to the followup results. General data, laboratory indicators, serum sCD40L and CD146 levels in the hypoperfusion group and the control group were compared. Univariate and bivariate Logistic regression analyses were conducted to analyze the risk factors influencing the prognosis of patients with regional blood perfusion after CIS. Spearman correlation analysis was performed to analyze the relationship between serum sCD40L and CD146 levels and the prognosis of patients with regional blood perfusion after CIS. Results Of the 102 patients, 56 (5490%) with regional blood perfusion were found by imaging examination. The sCD40L and mRS scores in the hypoperfusion group were significantly higher than those in the control group but CD146 levels were significantly lower than the control group (P＜005). The followup results of 56 patients with local blood perfusion after CIS showed that 9 patients had good prognosis and 47 patients had poor prognosis. The proportions of patients ≥60 years old, LDLC and sCD40L in the poor prognosis group were significantly higher than those in the good prognosis group. However, TC, HDLC and CD146 were significantly lower than the good prognosis group (P＜005). Bivariate Logistic regression analysis showed that sCD40L and CD146 levels were high risk factors for prognosis of patients with local blood perfusion after CIS (P＜005). Spearman correlation analysis showed that serum sCD40L levels in patients with local blood perfusion after CIS were significantly negatively correlated with the prognosis, while CD146 levels were significantly positively correlated with the prognosis (P＜005). Conclusion Serum sCD40L and CD146 levels are high risk factors affecting the prognosis of patients with local blood perfusion after CIS. Serum sCD40L and CD146 levels may be effective prognostic factor of patients with local blood perfusion after CIS.