The study analyzed 120 patients with acute ischemic stroke (AIS) admitted from January 2023 to December 2024, divided into a group with intravenous thrombolysis with alteplase and a group with a combination of thrombolysis and neurointerventional therapy (intra-arterial urokinase and possibly mechanical thrombectomy). After 3 months of treatment, the combination group had significantly lower NIHSS and mRS scores than the thrombolysis alone group (P < 0.05). In the combined group, the levels of inflammatory factors IL-6, TNF-α and hs-CRP were lower (P < 0.05). Combination treatment increased SOD levels, decreased MDA, increased CD4+ cell counts and CD4+/CD8+ ratio, while decreasing CD8+ cells (P < 0.05). Hemodynamically, the combined group showed higher minimum volume and cerebral blood flow velocity with lower peripheral resistance (P < 0.05). The combination group achieved a higher GQOLI-74 score, indicating a better quality of life (P < 0.05). The incidence of adverse reactions did not differ significantly between groups (P > 0.05). The conclusion of the study states that the combined treatment improves neurological function, reduces inflammation and oxidative stress, strengthens immunity, improves hemodynamics and quality of life with good safety.