Fructose for Acute Ischemic Stroke

Prior treatment

• Requiring or intending to continue using restricted medications that may interfere with study safety and implementation.
• Currently participating in another investigational drug or device study, or participation in other experimental treatment within less than 30 days prior to enrollment.

Other illness

• History of fructose intolerance, abnormal fructose metabolism or hereditary fructose metabolic disorders.
• Evidence of intracranial hemorrhage on CT scan, symptomatic intracranial hemorrhage, or clinical suspicion of subarachnoid hemorrhage.
• Any other conditions judged by the investigator to be inappropriate for enrollment.
• Pre-stroke mRS score ≥ 2, combined with dementia or other neurological disabling diseases.
• Complicated with severe medical history affecting endpoint evaluation and follow-up, such as craniocerebral trauma, multiple sclerosis, encephalitis, tumor, poisoning, syphilis, or severe cardiac, pulmonary, hepatic, renal and endocrine diseases.

Lab values

• History of diabetes mellitus or random blood glucose \> 11.1 mmol/L.
• Presence of hemorrhagic diathesis, including but not limited to:
  • Known hereditary bleeding tendency or severe bleeding disease within the past 6 months;
  • Received heparin within 48 hours before enrollment with aPTT exceeding the upper limit of laboratory reference range;
  • Current use of vitamin K-dependent oral anticoagulants with INR \> 1.7 or PT \> 15 s, or current use of novel oral anticoagulants with prolonged aPTT/PT above laboratory upper limit;
  • Platelet count \< 100,000/mm³ at screening;
  • History of central nervous system diseases such as tumor, aneurysm, intracranial or spinal surgery;
  • Received traumatic closed-chest cardiac massage, obstetric delivery or non-compressible vascular puncture within the past 10 days;
  • Suspected intracranial hemorrhage or aneurysmal subarachnoid hemorrhage;
  • Tumors with increased bleeding risk;
  • Peptic ulcer disease, esophageal varices, aneurysm, arterial/venous malformation within the past 3 months;
  • Any other known diseases associated with significantly elevated bleeding risk.
• Combined with severe hepatic and renal insufficiency (eGFR \< 30 mL/min/1.73m²).

Other

• Unable to complete cranial MRI examination due to implanted metal materials, claustrophobia or other reasons.
• Pregnant females.
• Refusal to sign informed consent.

• Aged between 18 and 85 years, male and female are both eligible.
• Clinical diagnosis of acute ischemic stroke meeting the diagnostic criteria of Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke.
• Time from stroke onset to hospital admission ≤ 4.5 hours, with new ischemic lesions confirmed by emergency multimodal cranial MRI (DWI/T2WI).
• Meeting the indications for intravenous thrombolysis, without absolute contraindications to thrombolysis, and planned to receive standard intravenous thrombolysis.
• Relatively stable vital signs, able to complete baseline and follow-up cranial MRI examinations including DWI, T2WI and ¹H-MRS, as well as NIHSS and mRS scale assessments.
• The patient or legal representative voluntarily participates in the study and signs written informed consent.