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目的探讨重组组织型纤溶酶（rt-PA）静脉溶栓治疗急性脑梗死的临床疗效及安全性。方法2011年7月~2012年11月对门急诊接治发病4.5h内的急性脑梗死患者35例给予rt-PA静脉溶栓治疗。结果静脉溶栓再通率51.4%（18例）,再通时间（90±30）min，再闭塞发生率8.5%（3例），无症状脑出血8.5%（3例），溶栓患者4w有效率74.3%（其中治愈率51.4%18例，显效率22.9%8例），无效率20%（7例），病死率5.7%（2例）。结论 rt-PA静脉溶栓治疗4.5h内急性脑梗塞安全有效，并改善预后。“,”Objective To explore the clinical efficacy and safety of alteplase on the vein thrombolysis treatment for acute cerebral infarction. Methods There were 35 cases about acute cerebral infarction were treatment by alteplase via vein thrombolysis treatment within 4.5 hours at outpatient and emergency from July 2011 to October 2012. Results The rate of recanalization about vein thrombolysis is 54.9%(18 cases),The time of recanalization is (90±30)min, the rate of reocclusion is 8.5%, the rate of no change is 8.5%, the rate of effective in 4 weeks is 74.3%.(basic cure rate is 51.4% 18 cases,effective rate is 22.9%), the rate of null and void is 20% 7 cases, the rate of died is 5.7% 2 cases. Conclusion In patients with acute cerebral infarction are cured by alteplase via vein thrombolysis in 4.5 hours that is safe and effective,in addition, improve the prognosis.