Tenecteplase Reperfusion Therapy in Acute Ischemic Cerebrovascular Events-Ⅱ

Inclusion Criteria: * Age ≥18 years old, no gender limitation; * The time from onset to treatment was \< 4.5h;The time at which symptoms begin is defined as "the time at which they finally appear normal"; * The clinical diagnosis was ischemic stroke (the diagnosis followed the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2018); * MRS before onset was 0-1 points * Baseline NIHSS 5-25(both included); * Informed consent from the patient or surrogate. Exclusion Criteria: * Intended to proceed endovascular treatment; * NIHSS consciousness score \>2; * Allergy to tenecteplase or alteplase; * Past history of intracranial hemorrhage ; * A history of severe head trauma or stroke within 3 months; * A history of intracranial or spinal surgery within 3 months; * A history of gastrointestinal or urinary bleeding within 3 weeks; * 2 weeks of major surgery; * Arterial puncture was performed at the hemostasis site that was not easily compressed within 1 week; * Intracranial tumors (except neuroectodermal tumors, such as meningiomas), large intracranial aneurysms; * Intracranial hemorrhage (including parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural/extradural hematoma, etc.); * Active visceral bleeding; * Aortic arch dissection was found; * After active antihypertensive treatment, hypertension is still not under control: systolic blood pressure ≥180 mm Hg, or diastolic blood pressure ≥100 mm Hg; * Propensity for acute bleeding, including platelet counts of less than 100×109/ L or otherwise; * Blood glucose \<2.8 mmol/L or \>22.22 mmol/L; * Oral warfarin anticoagulant with INR\>1.7 or PT\>15 s; * Heparin treatment was received within 24 h; * Thrombin inhibitors or factor Xa inhibitors were used within 48 h; * Head CT or MRI showed a large infarction (infarcted area \> 1/3 of the middle cerebral artery); * Subjects who are unable or unwilling to cooperate due to hemiplegia (Todd's palsy) after epileptic seizure or other neurological/psychiatric disorders; * Pregnant women, lactating women, or subjects who do not agree to use effective contraception during the trial; * Participation in other clinical trials within 3 months prior to screening; * Unsuitability or participation in this study as judged by the Investigator may result in subjects being exposed to greater risk.