Objective To investigate the clinical effect of thrombolysis with Alteplase in stroke patients and the changes of coagulation function and hemorheology.Methods A total of 120 cases of stroke patients in a hospital from October 2016 to October 2019 were selected as the research objects and randomly divided into control group and observation group,with 60 cases in each group.The therapeutic effects of the two groups were evaluated 10 days after treatment.The coagulation function(including fibrinogen[FIB],thrombin time[APTT],prothrombin time[PT]and platelet[PLT]),hemorheology indexes(plasma specific viscosity,whole blood high shear viscosity,erythrocyte aggregation index,blood cell volume)and incidence of complications(cerebral hemorrhage,gingival bleeding,rash or allergy,liver and kidney dysfunction and hematuria)were compared between the two groups.Results After treatment,Pt and APTT of the observation group were longer than those of the control group,the difference was statistically significant(P＜0.05),FIB and PLT levels of the observation group after treatment were lower than those of the control group,the differences were statistically significant(P＜0.05).After treatment,the plasma specific viscosity,whole blood high shear viscosity,erythrocyte aggregation index,blood cell volume of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).There was no significant difference in the incidence various of complications between the two groups during treatment(P＞0.05).Conclusion alteplase thrombolysis can improve the coagulation function and hemorheology indexes of stroke patients,and has high safety,which is worthy of clinical promotion.