目的　评价急性脑梗死溶栓治疗的适应症与疗效。方法　收集本院近 3年住院患者 ,凡符合入选标准的患者随机分为 2组 ,1组接受尿激酶 (UK)或基因重组纤溶酶原激活剂 (rt pA)溶栓治疗 ;另 1组给予常规神经营养药及活血化瘀中药等治疗 ,采用欧洲卒中量表 (ESS)及BarthelI(BI)评分来评价神经功能恢复情况。结果　治疗组溶栓治疗后ESS分数迅速增加 ,与对照组相比有显著性差异 ,30d后BI评分与对照组相比有显著性差异 ,平均住院日缩短 7.5d。治疗组病死率 1/ 34,对照组病死率 2 / 2 9。结论　溶栓治疗是急性脑梗死安全、有效的治疗方法 ,对进展性脑卒中时间窗可适当延长 ,大于 75岁的患者仍可溶栓治疗。 Objective To evaluate the indications and effects of thrombolysis in patients with acute cerebral infarction. Methods The hospitalized patients in our hospital for nearly three years were collected. All patients who met the inclusion criteria were randomly divided into two groups. One group received thrombolysis with urokinase (UK) or recombinant plasminogen activator (rt pA) Given conventional neurotrophic drugs and traditional Chinese medicine and other blood circulation therapy, the European stroke scale (ESS) and BarthelI (BI) score to evaluate the recovery of neurological function. Results The ESS score increased rapidly after thrombolysis in the treatment group, which was significantly different from the control group. After 30 days, the BI score was significantly different from the control group, and the average length of stay was shortened by 7.5 days. The treatment group mortality rate 1/34, the control group mortality 2/2 9. Conclusion Thrombolytic therapy is a safe and effective treatment for acute cerebral infarction. The time window of progressive stroke can be prolonged properly. Thrombolytic therapy is still available in patients older than 75 years old.