Abstract: Objective To investigate the clinical characteristics and 1-year prognosis of patients with acute recurrent cerebral infarction (ARCI) in Xi’an. Methods Through the Xi’an Stroke Registry, patients with acute cerebral infarction admitted to four Ⅲ-A hospitals in Xi’an from January to December 2015 were enrolled in this study. These patients were divided into the acute first-ever cerebral infarction (AFECI) group and ARCI group according to having previous history of cerebral infarction or not. The basic clinical characteristics and 1-year prognosis (stroke recurrence, poor functional outcome and death) between the two groups were compared. Poor functional outcome was defined as a mRS score >2 points. Results A total of 2230 patients were enrolled, with a median age of 65.0 (56.0-74.0) years and 1400 males (62.8%), 666 cases in ARCI group and 1564 in AFECI group. The average age,proportion of vascular risk factors (hypertension, diabetes, hyperlipidemia and peripheral vascular disease), premorbid mRS score, NIHSS score on admission, proportion of strokeassociated pneumonia and parenteral nutrition were higher and the level of lipids (TC, TG, HDL-C and LDL-C) and proportion of smoking were lower in the ARCI group than those in the AFECI

group, all the above differences were statistically significant. After adjusting for related confounders,

multivariate logistic regression analysis showed that the risk of 1-year stroke recurrence (OR 1.62, 95%CI 1.05-2.52, P =0.031), poor functional outcome (OR 1.40, 95%CI 1.06-1.85, P =0.017) and death (OR 1.51, 95%CI 1.02-2.23, P =0.037) in patients with ARCI all significantly increased. Conclusions The risk of 1-year stroke recurrence, poor functional outcome and death in patients with ARCI in Xi’an was all high, which suggested that clinicians should pay attention to the screening of the causes and prevention of stroke, to reduce the risk of poor prognosis of such patients in Xi’an.

Key words: Acute recurrent cerebral infarction; Acute first-ever cerebral infarction; Clinical characteristics; Prognosis

摘要： 目的 探讨西安地区急性复发性脑梗死（acute recurrent cerebral infarction，ARCI）患者的临床特征 及1年预后。 方法 通过西安卒中登记研究，纳入西安市4所三级甲等医院2015年1-12月连续收治的急性脑梗死 患者，根据是否合并既往脑梗死病史分为急性首发脑梗死（acute first-ever cerebral infarction，AFECI） 组和ARCI组。比较两组的临床特征，并分析1年卒中复发、预后不良（mRS＞2分）及死亡风险差异。 结果 最终纳入2230例急性脑梗死患者，中位年龄65.0（56.0～74.0）岁，男性1400例（62.8%）； ARCI组666例，AFECI组1564例。ARCI组年龄、血管危险因素（高血压、糖尿病、高脂血症、周围血管病） 比例、发病前mRS评分、入院NIHSS评分，以及卒中相关性肺炎和需要肠外营养比例高于AFECI组，血 脂水平（TC、TG、HDL-C和LDL-C）低于AFECI组，以上差异均有统计学意义；两组吸烟指标差异有统计 学意义，其中ARCI组目前仍吸烟比例低于AFECI组。多因素logistic回归分析结果显示，ARCI组患者的1年 卒中复发（OR 1.62，95%CI 1.05～2.52，P =0.031）、预后不良（OR 1.40，95%CI 1.06～1.85，P =0.017） 及死亡风险（OR 1.51，95%CI 1.02～2.23，P =0.037）均显著升高。 结论 西安地区ARCI患者的1年卒中复发、预后不良及死亡风险均较高，提示临床需重视卒中病因 的筛查和防治，以降低区域内该类患者的不良预后风险。

关键词: 急性复发性脑梗死; 急性首发脑梗死; 临床特征; 预后