The primary aim of the study is to investigate the relationships among FVIII, t-PA/PAI-1, MMP-9 levels, and intracranial hemorrhage after thrombolysis with alteplase using a combined analysis.

Patients with acute ischemic stroke treated with alteplase within 4.5 hours after the onset of stroke symptoms will be recruited in this study. All participants will be divided into two groups according to whether intracranial hemorrhage occurred within 3 days after treatment with alteplase for analysis. Differences in FVIII, t-PA/PAI-1, and MMP-9 levels before and after thrombolytic therapy will be examined in both groups. This study will be conducted at Zhujiang Hospital of Southern Medical University, Nanfang Hospital of Southern Medical University, and the First Affiliated Hospital of Jinan University.

Inclusion Criteria:

• Diagnosis of ischemic stroke and within the time window of thrombolysis (Onset of symptoms no more than 4.5 hours )
• 18 y age 85 y•
• Symptoms of neurological deficits caused by cerebral infarction
• Informed consent form to confirm thrombolytic therapy have signed by patients or their family.

Exclusion Criteria:

• A history of major head trauma or stroke in the past 3 months
• Suspicious subarachnoid hemorrhage
• Arterial puncture at noncompressible site in the last week
• History of intracranial hemorrhage
• Intracranial neoplasm, arteriovenous malformation, or aneurysm
• Recent intracranial or intraspinal surgery
• Elevated blood pressure (systolic >185 mm Hg or diastolic >110 mm Hg)
• Active internal bleeding or Acute bleeding diathesis
• Platelet count <100×109·L-1
• Heparin received within 48 h resulting in aPTT above the upper limit of normal
• Current use of anticoagulant with INR >1.7 or PT >15 s
• Current use of thrombin inhibitors or factor Xa inhibitors
• Abnormal laboratory tests (eg, aPTT, INR, platelet count, ECT, TT, or appropriate factor Xa activity assays)
• Blood glucose concentration > 2.7 mmol/L
• CT demonstrates multilobar infarction (hypodensity >1/3 cerebral hemisphere)
• Mild cerebral infarction or rapid improvement of symptoms of cerebral infarction
• Symptoms of neurological impairment after seizures
• Major surgery or severe trauma in the past 2 weeks
• Gastrointestinal or urinary bleeding in the past 3 weeks
• History of myocardial infarction in the past 3 months
• Combine diseases that may affect outcomes,such as Anemia, hemophilia
• History of autoimmune disease or organ transplantation
• Pregnancy or breastfeeding women

Patients with ischemic stroke treated with Alteplase