目的:探讨血小板平均体积(MPV)和血小板分布宽度(PDW)对颈动脉狭窄程度的预测。方法:选择2023年1月至2023年12月青岛大学附属医院收治的265例颈动脉狭窄患者进行回顾分析。根据患者头颈部血管CT显像结果和北美症状性颈动脉内膜切除术试验协作组(NASCET)标准,将患者分为轻度狭窄组(狭窄 Objective: To investigate the predictive value of mean platelet volume (MPV) and platelet distribution width (PDW) on the degree of carotid artery stenosis. Methods: A retrospective analysis was conducted on 265 patients diagnosed with carotid artery stenosis who were admitted to the Affiliated Hospital of Qingdao University between January and December of 2023. The patients’ head and neck vascular CT imaging results were then categorized into three groups according to the criteria established by the North American Symptomatic Carotid Endarterectomy Trial Collaborative Group (NASCET): mild stenosis (stenosis < 30%), moderate stenosis (30% ≤ stenosis < 85%), and severe stenosis (stenosis ≥ 85%). The clinical data and related laboratory indicators of the study participants were meticulously collected. Patients’ general data were systematically enumerated, laboratory data were objectively compared between groups, and the correlation with the degree of carotid artery stenosis was systematically analyzed. Results: The study revealed a positive correlation between PDW and the degree of carotid artery stenosis. Concurrently, HDL demonstrated a negative correlation with the severity of carotid artery stenosis. The findings further indicated that both PDW and HDL independently influenced carotid artery stenosis. However, no significant correlation was observed between MPV and carotid artery stenosis, indicating that other factors might be involved in the etiopathogenesis of this condition. Conclusions: Increased PDW exhibits a direct correlation with the severity of carotid artery stenosis and can serve as a predictive index to evaluate the sever