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Objective: To study Effect of tirofiban combined with butylphthalide on serum Heme oxygenase-1（HO-1), nitric oxide（NO), angiogenin-1（ANG-1), vascular endothelial growth factor（VEGF） in patients with acute cerebral infarction beyond time window.Methods: 141 patients with acute cerebral infarction beyond the time window treated in our hospital from January 2018 to January 2020 were selected and divided into combination group（n=71） and single drug group（n=70） by random number table method. The mono-drug group was given butylphthalide treatment, and the combination group was given tirofiban treatment on the basis of mono-drug group.Clinical efficacy, HO-1, NO, VEGF, ANG-1, the National Institutes of Health Stroke Scale（NIHSS), Barthel index（Barthel), thrombin time（TT), prothrombin time（PT), fibrinogen（FIB） levels and the incidence of drug complications were compared between the two groups. Results: After treatment, the total effective rate of the two groups was significantly different（P<0.05）; before treatment, there was no significant difference in serum HO-1, no, VEGF, Ang-1 between the combined group and the single drug group; after treatment, the serum HO-1, no, VEGF in the combined group and the single drug group decreased with time, and the combined group was lower than the single drug group, and Ang-1 increased with time, and the combined group was higher than the single drug group, the difference was significant Before treatment, there was no significant difference in NIHSS and Barthel between the combined group and the single drug group; after treatment, NIHSS in the combined group and the single drug group decreased with the passage of time, and Barthel in the combined group increased with the passage of time, and the combined group was higher than the single drug group, the difference was significant（P<0.05). Conclusion: The effect of tirofiban combined with butylphthalide in patients with acute cerebral infarction over time window is significant, which may be related to the effective improvement of serum HO-1, no, VEGF, Ang-1 levels, and does not increase adverse reactions. [ABSTRACT FROM AUTHOR]