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This study aimed to investigate the effects of alteplase on patient neurological function and serum levels of stromal cell-derived factor-1 (SDF-1), claudin-5, neuron-specific enolase (NSE), coagulation factor VIII (FVIII), von Willebrand factor (vWF), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β). We randomly categorized 85 patients into a control group (n = 42) and an observation group (n = 43). Patients in the control group received routine and batroxobin treatments, whereas those in the observation group received routine and alteplase thrombolytic treatments. Two groups were compared in terms of therapeutic effect; serum levels of SDF-1, claudin-5, and NSE; coagulation indicators of FVIII and vWF; thrombin time (TT); serum inflammatory factors of TNF-α, IL-1β, and interleukin-6 (IL-6); and adverse reactions. The total effective rate of the observation group was higher than that of the control group. With the extension of treatment time (6 h-2 weeks), NIHSS score decreased in both groups, and the NIHSS score of the observation group at 6, 12, 24 h, 7 d and 2 weeks after treatment was lower than that of the control group. In conclusion, Alteplase shows enhanced clinical efficacy in patients with acute cerebral infarction.