Objective        To determine the effect hyperhomocystinemia on the efficacy of intravenous thrombolysis with atleplase in patients with acute ischemic stroke.       Methods        A total of 162 consecutive eligible patients with acute ischemic stroke hospitalized in our hospital from January 2010 to January 2013 were enrolled in this study. They were all treated with recombinant tissue plasminogen activator

atleplase. In 90 d after treatment

modified Rankin scale (mRS)  was used to evaluate the patients

and according to the results

they were divided into favorable outcome group (defined as 0 to 1) and adverse outcome group (as 2 to 6). Univariate analysis and multivariate logistic regression analysis were used to determine the differences of clinical data between the 2 groups.       Results        According to the mRS score

there were 88 cases getting favorable outcome

while 74 cases adverse outcome

with the formers having younger age

lower NIHSS score before thrombolysis

lower blood glucose

lower international normalized ratio (INR)

and lower systolic blood pressure (SBP) at the 2nd and 24th hours after thrombolysis (P0.05

P0.01). The favorable outcome group also had less patients suffering from hyperhomocystinemia and diabetes than the adverse outcome group (P0.01). But there was no significant difference in other indexes between the 2 groups (P0.05). Multivariate logistic analysis revealed that diabetes

blood glucose before thrombolysis

NIHSS score before thrombolysis

SBP at the 2nd and 24th hours after thrombolysis and hyperhomocystinemia were independent risk factors for patients receiving atleplase treatment for intravenous thrombolysis.       Conclusion        Hyperhomocystinemia exerts effect on the prognosis of intravenous thrombolysis with atleplase in acute ischemic stroke.