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【目的】分析应用中分子羟乙基淀粉注射液强化灌注治疗对已行溶栓治疗的急性缺血性卒中患者神经功能预后的影响。【方法】连续录入本院应用阿替普酶注射液溶栓治疗的急性缺血性脑卒中患者64例，并利用随机数字表方法将上述患者分成两组，每组32例。两组患者均在时间窗内应用阿替普酶注射液行溶栓治疗后，采用标准急性缺血性卒中治疗方法继续治疗，而治疗组患者则在上述基础上加用7 d中分子羟乙基淀粉注射液500 mL静脉点滴强化灌注治疗。对录入患者按中国缺血性卒中分型（CISS）标准分型，并于入院时、溶栓后24 h、出院及出院后90 d依据美国国立卫生研究院脑卒中量表（NIHSS）进行评分比较。【结果】治疗组与对照组患者入院及超短期神经功能评分相比较差异均无显著性（P ＞0．05），而短期及长期神经功能评分相比较差异具有显著性（ P ＜0．05）。特别对于大动脉粥样硬化亚组患者，治疗组与对照组短期及长期神经功能评分相比较差异更为显著（ P ＜0．01）。【结论】对于急性缺血性脑卒中患者在时间窗内行阿替普酶治疗可显著改善神经功能预后，而对于发病机制为大动脉粥样硬化的患者，特别是对低灌注机制患者而言，溶栓治疗后再行强化灌注治疗对于短期、长期神经功能的改善显得尤为重要。“,”[Objective]To examine whether or not medium‐molecular‐weight hydroxyethyl starch can improve the prognosis of patients with acute ischemic infarction (ACI) after tissue plasminogen activator (rt‐PA) therapy .[Methods]A total of 64 successive ACI patients on rt‐PA therapy were divided into control and trial groups by ran‐dom number table method ( n=32 each) .All patients received standard therapy for ACI .And the trial group had an additional injection of medium‐molecular‐weight hydroxyethyl starch injection 500 ml for 7 successive days . They were classified into different types according to the Chinese Ischemic Stroke Sub‐classification (CISS) .Neu‐rological deficit was assessed by the National Institute of Health Stroke Scale (NIHSS) upon admission ,24h treat‐ment ,at discharge and 90 days after .[Results]Upon admission and during treatment ,no significant inter‐group difference existed ( P>0 .05) .However ,there were significant inter‐group differences for patients with large‐ar‐tery atherosclerosis ,especially with hypo‐perfusion ( P < 0 .05) .[Conclusion]The use of medium‐molecular‐weight hydroxyethyl starch can obviously improve neuro‐functional prognosis for ACI patients after rt‐PA therapy , especially for large‐artery atherosclerosis with hypo‐perfusion .