Abstract: Abstract: Objective To compare the effects of different time windows of alteplase on cognitive function in patients with cerebral infarction. Methods Ninety-five patients with cerebral infarction who were treated in our hospital from January 2016 to April 2018 were divided into two groups according to the time of intravenous thrombolytic therapy with alteplase. The observation group included patients with thrombolytic time <3 h, and the control group consisted of 50 patients with 3 to 4.5 h from onset to thrombolysis. The therapeutic effects, neurological recovery, cognitive function and cerebral hemorrhage were analyzed in the two groups. Results After 7-day treatment, there was no significant difference in the total effective rate between the two groups (88.9% vs. 82.0%, P＞0.05). The NIHSS score and MESSS score were significantly higher after one-day and seven-day treatment with alteplase than those before treatment in two groups (all P＜0.05). At the same time, the NIHSS scores and MESSS scores were significantly lower after one-day and seven-day treatment in the observation group［(7.13±2.42) points, (4.85±1.76) points for NIHSS and(8.48±2.72) points, (5.61±2.05) points for MESSS］ than those of control group [(8.48±2.86) points, (6.08±2.31) points for NIHSS and (10.08±3.09) points, (7.23±2.81) points for MESSS, P＜0.05]. After 7-day treatment, the MRS scores were significantly better in the observation group (good prognosis 91.11%, poor prognosis 8.89% and no death) than those of the control group［good prognosis 76.00%, poor prognosis 20.00% and death 4.00%, P＜0.05]. After 7-day treatment, the incidence rate of cerebral hemorrhage was 2.22% in the observation group, which was significantly lower than that of the control group (14.00%, χ2=4.260, P＜0.05). Conclusion Arteplase intravenous thrombolytic therapy (<3 h from onset to thrombolysis) can significantly improve the neurological and cognitive functions in patients with cerebral infarction and reduce the incidence of cerebral hemorrhage.

Key words: cerebral infarction, alteplase, intravenous thrombolysis, different time windows, neurological function, cognitive function