Clinical efficacy comparison of tenecplase and alteplase in the treatment of acute ischemic stroke
Zhang Feng
Ma Xiaodong
Xi Zhenhua
Yao Hong
Shi Weiliang
Abstract：Objective To explore the clinical efficacy of tenecplase and alteplase in the treatment of acute ischemic stroke within 4.5 hours after onset.Methods This study enrolled 50 patients with acute ischemic stroke who visited our hospital from June 2023 to June 2025.The patients were randomly divided into two groups,respectively receiving tenecteplase and alteplase for treatment,with 25 cases in each group.All eligible patients received corresponding intravenous thrombolysis within the 4.5-hour time window after onset.The primary objective of the study was to systematically compare and evaluate the efficacy of the two treatment regimens..Results Significantly more patients were effectively treated in the tenecteplase group than in the alteplase group(P<0.05).Both groups demonstrated reduced NIHSS scores at 24 hours and 7 days after treatment,with a more pronounced decrease in tenecteplase group(P<0.05).At 90 days,there was 1 death in tenecteplase group,and 4 in alteplase group.Both groups showed decreased mRS scores,with a more pronounced decrease in the tenecteplase group(t=13.628,P<0.05).At 24 hours post-treatment,coagulation function improved in both groups,with more significant enhancement in the tenecteplase group(P<0.05).At 7 days post-treatment,both groups showed improvement in coagulation function compared to baseline,though the inter-group difference was not statistically significant(P>0.05).There was no significant difference in the occurrence of adverse reactions between groups(χ2=0.136,P>0.05).Follow-up calls at 90 days post-treatment revealed 1 case of recurrence in tenecteplase group,and 7 in alteplase group(4.00%vs 28.00%,χ2=5.357,P<0.05).Conclusion Both tenecplase and alteplase have certain clinical efficacy in the treatment of acute ischemic stroke within 4.5 hours after onset.However,tenecplase is superior to alteplase in improving coagulation function and neurological function,and can effectively reduce the recurrence rate.Its safety is comparable to that of alteplase.Therefore,it can be used as the preferred drug for the treatment of acute ischemic stroke.
Keywords：TeneplaseAcute ischemic strokeThrombolytic therapy
Publication Date：2025-10-20
Online Publishing Date：2026-03-25(First online date of this platform, not the publication date of the document)
Pages：5( 71-75 )