Abstract: Objective　To investigate the effect of intravenous thrombolysis with alteplase combined with butylphthalide on neurological function and coagulation function in patients with acute severe cerebral infarction. Methods　A total of 120 patients with acute severe cerebral infarction were divided into the control group and the observation group according to different treatment methods, with 60 cases in each group. The control group was treated with alteplase intravenous thrombolysis, and the observation group was treated with alteplase intravenous thrombolysis combined with butylphthalide for 14 days. The curative effects and the National Institutes of Health Neurological Deficit Score (NIHSS) were compared between the two groups. The coagulation function was measured by automatic coagulation analyzer, and the neurotransmitter level was measured by high performance liquid chromatography. Changes of cerebral blood flow perfusion were detected by cerebral perfusion CT, and the incidence of adverse reactions during treatment was recorded in the two groups of patients. Results　The clinical efficacy and total effective rate were better in the observation group than those of the control group (P＜0.05). The NIHSS of the two groups were significantly lower after treatment than those before treatment, and the decrease was more significant in the observation group (P＜0.05). The values of serum prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), dopamine (DA), serotonin (5-HT), cerebral blood flow (CBF) and cerebral blood volume (CBV) were higher in the observation group than those in the control group (P＜0.05), and the values of fibrinogen (FIB) and mean transit time (MTT) were lower than those in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (11.67% vs. 8.33%, P＞0.05). Conclusion Intravenous thrombolysis with alteplase combined with butylphthalide can effectively improve cerebral blood flow perfusion and coagulation function in patients with acute severe cerebral infarction, promote the repair and reconstruction of neurological function, and has high safety, which is worthy of clinical recommendation.

Key words: tissue plasminogen activator, brain infarction, neurological rehabilitation, blood coagulation tests, butylphthalide, acute severe cerebral infarction, cerebral blood flow perfusion