Abstract: Objective  To observe the effect of local mild hypothermia combined with recombinant human tissue type plasminogen activator(rt-PA) intravenous thrombolysis on oxidative stress, neurological damage and prognosis in patients with acute massive cerebral infarction. 
Methods  A total of 79 patients with acute large area cerebral infarction were divided into the observation group(41 cases) and the control group(38 cases). The control group was treated with rt-PA intravenous thrombolysis on the basis of symptomatic treatment, and the observation group was treated with mild hypothermia on the basis of the control group. The superoxide dismutase(SOD), malondialdehyde(MDA), heart type fatty acid binding protein(H-FABP), N-terminal pro-B type natriuretic peptide(NT-proBNP) between two groups before and 7 days after treatment were compared. The levels of NT proBNP, neuron specific enolase(NSE), S100β protein, and NIH stroke scale(NIHSS) score and recovery of daily activities［barthel index(BI)］, the incidence of adverse reactions were compared. 
Results  After treatment, SOD in two groups was higher than that before treatment, MDA was lower than that before treatment, SOD in observation group was higher than that in control group and MDA was lower in control group, the difference was statistically significant(P＜0.01). The levels of H-FABP, NT-proBNP, NSE and S100β in the two groups were lower than those before treatment, while the levels of H-FABP, NT-proBNP, NSE and S100β in the observation group were lower than those in the control group(P＜0.01). NIHSS score of two groups was lower than that before treatment, BI was higher than before treatment, NIHSS score of observation group was lower than that of control group, BI was higher than that of control group, the differences were statistically significant(P＜0.01). There was no significant difference in the incidence of adverse reactions between two groups within 7 days(P＞0.05). 
Conclusion  Iocal mild hypothermia combined with rt-PA intravenous thrombolysis can significantly improve the clinical effect of acute large area cerebral infarction, reduce the degree of oxidative stress and brain nerve injury, reduce the level of related nerve injury factors, and improve the prognosis of patients.

Key words: brain infarction； mild hypothermia, intravenous thrombolysis