临床上当前常用的溶栓药物主要是尿激酶以及阿替普酶（rt-PA）。阿替普

The currently commonly used thrombolytic drugs in clinical practice are mainly urokinase and alteplase (rt-PA). Alteplase is an endogenous enzyme with high specificity for fibrin. It can bind to the fibrin in the thrombus, activate the fibrin in the blood, and degrade the fibrin, because it is mainly activated locally in the thrombus, and then has a local thrombolytic effect [15]. <br><br><br>Khaled et al. believe that [16] intravenous rt-PA also has a positive effect on the recovery of neurological function in patients with acute ischemic cerebrovascular disease. Maier et al.'s research also believes that [17] rt-PA treatment can improve the functional prognosis of eligible patients, but further studies are still needed to confirm and determine the conditions of patients most likely to benefit from it. Among them, blood glucose level is the main influencing factor of thrombolytic effect. The higher the blood glucose level of patients before the application of thrombolytic drugs such as rt-PA, the worse the effect. Controlling blood sugar within a certain range is beneficial to improve the therapeutic effect of thrombolytic drugs [18]. <br>Due to the multi-mechanism of ischemic cerebrovascular disease, including local brain tissue ischemia and hypoxia, its brain cells exhibit an electrochemical cascade cascade reaction, which is coupled with signal pathways in damaged brain cells, and then Lead to damage to the function of the central nervous system [19]. Therefore, multi-target drugs are of great significance in their treatment. Butylphthalide has become an important adjunct to ischemic cerebrovascular disease, and studies believe that it can also improve severe cognitive dysfunction syndrome caused by insufficient brain tissue perfusion [20]. Butylphthalide may have the following mechanism of action for the treatment of ischemic cerebrovascular disease: by inhibiting the transition of M1 microglia/macrophages to M2 phenotype, thereby reducing nervous system damage and blood-brain barrier damage [21]. Sequential treatment of butylphthalide can also effectively increase the plasma level of 3-MST and reduce the plasma level of Aβ42, which is beneficial to improve the living ability and neurological function of patients, and improve the activities of daily living. It has high safety. 【twenty two】. <br>Our research suggests that although the NHISS scores of the two groups of patients after treatment were improved compared with before treatment (p 0.05). However, patients who received alteplase combined with butylphthalide treatment improved more significantly (p=0.00); about 67.5% of the patients in the experimental group recovered well after treatment, and about 45% of the control group recovered well after treatment (p=0.04) ); and there was no significant difference in the incidence of complications between the two groups within 1 week after treatment (p=0.56).<br>To sum up, the combination of alteplase and butylphthalide in the treatment of patients with acute anterior circulation cerebral infarction has significantly improved symptoms, high effective rate, significant recovery of nerve function, and no significant increase in the incidence of complications. <br>The shortcomings of this study are the small number of included cases and short follow-up time. Only patients within 6 hours of onset were analyzed in general terms. The therapeutic effect and prognosis of patients with alteplase combined with butylphthalide in different time windows are not further refined. We are also actively accumulating cases, and further improving the data on patient treatment in different time windows, and continue to increase the follow-up time, in order to elaborate on the defects and long-term effects of the treatment plan in more detail. <br>references:

Clinically commonly used thrombolytic drugs are mainly urinary kinases and atipase (rt-PA). Atipase is an endogenetic enzyme with high specificity to fibrin. It can bind to fibrin in blood clots, activate the fibrinase in the blood, and degrade the fibrin, because it is mainly activated in the local thrombosis, and then play the effect of local thrombosis.<br><br>Khaled and other studies have concluded that intravenous rt-PA also has a positive effect on the recovery of nerve function in patients with acute isohemic cerebrovascular disease. Studies such as Maier's also suggest that rt-PA treatment can improve the functional prognosis of eligible patients, but further research is needed to confirm and determine the patient conditions most likely to benefit from it. Among them, blood glucose level is the main factor of thrombolytic effect, the higher the blood sugar level of patients before the application of thrombolytic drugs such as rt-PA, the worse the efficacy. The control of blood sugar within a certain range is beneficial to improve the therapeutic effect of thrombolytic drugs.<br>Due to the multi-mechanism disease of ischemic cerebrovascular disease, including local brain tissue ischemic, hypoxia, its brain cells appear electrochemical cascading waterfall-like reaction, and the signaling path in the damaged brain cells, which in turn leads to damage to the function of the central nervous system. Therefore, multi-target drugs are very important in their treatment. Butyl benzene has become an important auxiliary means of isomorphic cerebrovascular disease, and it is believed that it can also improve severe cognitive dysfunction syndrome caused by insufficient perfusion of brain tissue. Butylphenidate may have the following mechanisms for the treatment of isohemic cerebrovascular disease: by inhibiting the transition of M1 small glial cells/macrophages to M2 phenids, neurological damage and damage to the blood-brain barrier are mitigated. Butyl benzene sequentepsis treatment can also effectively improve the plasma level of 3-MST, reduce the plasma level of A beta 42, is conducive to improve the patient's life ability and nerve function, improve daily life activities, with high safety. 【22】。<br>Our study suggests that both groups of patients showed improved NHISS scores after treatment (p 0.05) than before treatment. However, the improvement was more pronounced in patients treated with atipase combined butyl benzene (p-0.00), about 67.5% of patients recovered well after treatment in the experimental group, and about 45% recovered well in nerve function after control group treatment (p-0.04), while there was no significant difference in the incidence of complications in both groups within 1 week of treatment (p-0.56).<br>To sum up: Atipase combined with butyl benzene to treat patients with acute pre-circulatory cerebral infarction symptoms improved significantly, high efficiency, nerve function recovery significantly, and the incidence of complications did not increase significantly.<br>The shortcoming of this study is that the number of cases included in the study is small and the follow-up time is short. Only patients within 6h of the disease were analyzed in general terms. There was no further refinement of the therapeutic effect and prognosticity of the application of atipase to butylphenidate in patients with different time windows. We are also actively accumulating cases, further refining the information on patient treatment within different time windows, and continuing to increase follow-up time with a view to elaborating in more detail on the shortcomings and long-term effects of the treatment.<br>References:

Urokinase and alteplase (RT PA) are commonly used thrombolytic drugs in clinic. Alteplase is an endogenous enzyme with high specificity for fibrin. It can combine with fibrin in thrombus, activate fibrin in blood and degrade fibrin, because it is mainly activated in local thrombus, and then play the effect of local thrombolysis [15].<br>According to Khaled et al. [16] intravenous injection of RT PA has a positive effect on the recovery of neurological function in patients with acute ischemic cerebrovascular disease. Maier et al. Also believe that [17] RT PA treatment can improve the functional prognosis of eligible patients, but further research is needed to confirm and determine the patient conditions most likely to benefit from it. Among them, the blood glucose level is the main influencing factor of thrombolytic effect. The higher the blood glucose level is before the application of thrombolytic drugs such as RT PA, the worse the curative effect is. However, controlling blood glucose within a certain range is conducive to improving the therapeutic effect of thrombolytic drugs [18].<br>Due to the multi mechanism pathogenesis of ischemic cerebrovascular diseases, including local cerebral ischemia and hypoxia, the brain cells show electrochemical cascade like reaction, which is coupled with the signal pathway in the damaged brain cells, thus leading to the functional impairment of the central nervous system [19]. Therefore, multi-target drugs are of great significance in its treatment. Butylphthalide has become an important auxiliary means of ischemic cerebrovascular disease, and it is also believed that butylphthalide can improve the severe cognitive dysfunction syndrome caused by insufficient cerebral perfusion [20]. Butylphthalide may have the following mechanism in the treatment of ischemic cerebrovascular disease: it can reduce the damage of nervous system and the damage of blood-brain barrier by inhibiting M1 microglia / macrophage phenotype transformation [21]. Butylphthalide sequential treatment can also effectively improve the plasma level of 3-mst and reduce the plasma level of a β 42, which is conducive to improve the living ability and nerve function of patients, improve the activities of daily living, and has high safety. 【22】。<br>Our study suggested that although the nhiss scores of the two groups were improved after treatment compared with those before treatment (P 0.05). However, the improvement of patients receiving alteplase combined with butylphthalide was more obvious (P = 0.00); after treatment, about 67.5% of the patients in the experimental group recovered well, and about 45% of the patients in the control group recovered well (P = 0.04); however, there was no significant difference in the incidence of complications between the two groups within 1 week after treatment (P = 0.56).<br>In conclusion: alteplase combined with butylphthalide in the treatment of patients with acute anterior circulation cerebral infarction symptoms improved significantly, the effective rate was high, the recovery of neurological function was significant, and the incidence of complications was not significantly increased.<br>The deficiency of this study lies in the small number of cases included and the short follow-up time. Only patients within 6 hours of onset were analyzed. The therapeutic effect and prognosis of alteplase combined with butylphthalide in different time windows were not further refined. We are also actively accumulating cases, and further improving the treatment data of patients in different time windows, and continue to increase the follow-up time, in order to elaborate the defects and long-term effect of the treatment scheme.<br>reference:<br>