Objective To observe the effect of butylphthalide sequential therapy combined with injection of alteplase(injection with recombinant human collagenous tissue plasminogen activator) in the treatment of acute cerebral infarction (ACI).Methods 61 patients with ACI and within 4.5 hours of onset were selected,and they were divided into treatment group(butylphthalide combined with alteplase group,31 cases) and the control group (alteplase only group,30 cases) by random number table.The two groups were given glucose-lowering,statins for maintaining the blood pressure,as well as aspirin enteric tablets or clopidogrel for those without bleeding on the 24 hour review head CT in the acute phase.The treatment group was given alteplase for injection with sequential butylphthalide therapy (butylphthalide injection for 2 weeks followed by an oral administration of butylphthalide soft capsules for 3 months),and the control group was given only alteplase for injection.The National Institute of Health stroke scale (NIHSS) and Barthel index (BI) were used for evaluating the final clinical efficacy.Results The NIHSS scores of the treatment group compared with the control group at 24 hour,14 days and 3.5 months after the treatment had statistically significant differences (t =-0.102,-1.964,-2.444,P =0.037,0.018 and 0.012).The NIHSS scores of the treatment group had decreased 2％,27％ and 41％ compared with the control group at 24 hour,14 days and 3.5 months after the treatment,respectively.The BI score of the treatment group and control group at 3.5 months after treatment had statistically significant difference (t =-1.956,P =0.029).Conclusion The sequential butylphthalide therapy combined with injection of alteplase has good synergistic effect for the patients with onset of ACI less than 4.5 hours,and it is a safe and effective treatment method for ACI within 4.5 h and it is worthy of clinical promotion.

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