Thrombolysis Treated With TNK-tPA in Acute Ischemic Stroke Patients （3T Stroke-II）

Inclusion Criteria: * Age ≥18 years old; * The clinical diagnosis was Acute ischemic stroke 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"; * mRS before onset was ≤1 points; * Baseline NIHSS (at the time of randomization) should be \> 5 and ≤25 points; * Informed consent from the patient or surrogate. Exclusion Criteria: * Intracranial hemorrhage identified by CT or MRI (CMBs detected by SWI is not counted); * Massive anterior cerebral infarction identified by CT or MRI (ASPECT \< 6 or lesions larger than one third of the territory of the middle cerebral artery or with a volume larger than 70mL) * A history of severe CNS damage (such as aneurysm or arteriovenous malformation, craniocerebral trauma, intracranial or spinal cord surgery) * Onset with seizures, and the paralysis was suspected to be related to Todd paralysis. * Administration of heparin within 48 hours preceding the onset of stroke with a baseline APTT exceeding the upper limit of the normal range. * Oral anticoagulant (such as warfarin) treatment with baseline INR\>1.7 or PT\>15 s; * Administration of thrombin inhibitors or factor Xa inhibitors within 48 hours preceding the onset of stroke with abnormal coagulation parameters or platelet count; * BP couldn't be controlled with aggressive treatment. Uncontrolled hypertension was defined as systolic blood pressure \>185 mmHg or diastolic blood pressure \>110 mmHg, measured for three times every 10 minutes. * Platelet count of less than 100×109/ L; * Blood glucose \<50 mg/dl (\<2.8 mmol/L) or \>400 mg/dl (22.22 mmol/L); * History of intracranial hemorrhage or active hemorrhagic disease. (Such as gastrointestinal, urinary tract or retinal bleeding) * Tumors with an increased risk of bleeding. * Prolonged or traumatic cardiopulmonary resuscitation (\>2 min), delivery within the last 10 days or recent puncture of non-compression vessels such as subclavian vein or jugular vein * Acute pancreatitis or severe liver disease, including liver failure, cirrhosis, portal hypertension, esophageal varicose veins, and active hepatitis; * Aortic arch dissection; * Major surgery or severe trauma in the past 2 weeks; * Subjects had serious, fatal, or disabling disease with an expected survival of less than 3 months; * Unable to complete neurological assessment and follow-up visits because of dementia or mental illness; * Pregnant women, lactating women, or have positive pregnancy test; * Allergy to tenecteplase or alteplase or their components; * Participation in other clinical trials within 3 months prior to screening; * Unsuitable to involve in this study or would result in increased risk, as judged by the investigators.