中文摘要：

目的：研究脑梗死长期复发的部位是否在同一脑循环系统。方法：回顾性研究了北京大学人民医院神经内科3年内全部有头颅磁共振证实初次脑梗死的住院患者，电话随访和电子病历相结合确定其为5年内单发或复发。对复发的病例录入基本资料和影像学资料，并将复发病例按复发部位是否在同一脑循环系统分为两组，应用Logistics回归筛选各个变量是否为复发部位在同一脑循环系统的独立危险因素。结果：复发组106例，5年内在同一脑循环系统总复发比率为46．2％，在不同系统总复发比率为53．8％，Logistic回归筛选发现复发部位是否在同一脑循环系统与年龄、性别、高血压、糖尿病、吸烟等无相关性，而与生存时间（复发时间）相关，复发时间越短越倾向于在相同脑循环系统复发，而复发时间越长，越倾向于在不同脑循环系统复发。并且第1年复发总例数最多，占5年内复发总数的37％。结论：通过对脑梗死5年内复发的部位进行研究，发现越是长期复发，部位越倾向于在不同脑循环系统，从而强调了长期药物治疗的重要性，但是在短期，尤其1年内，相同脑循环系统复发的几率较大（60．0％），从而证明了大动脉粥样硬化性脑梗死早期1年内给予血管内治疗的合理性。

英文摘要：

Objective To research the location in cerebral circulations of recurrent stroke. Methods We included patients with acute cerebral infarction from the Department of Neurology of People＇s Hospital of Peking University within three years. We followed up the patients by telephone and electronic medical record to determine whether they belong to recurrent group or not. We recorded the clinical and image variables of recurrent group. We classified the recurrent group by whether the loci of recurrent stroke is in the same circulation. We determined the independent risk factors of the same circulation loci by Cox regression. Results There are 106 cases of recurrent stroke. Within 5 years, 46.2% of the cases had recurrent loci in the same circulation as first stroke loci. 53.8% of the cases had recurrent loci in the different circulation from first stroke loci. According to logistic regression, whether the recurrent loci was in the same circulation was not related to age, sex, hypertension, diabetes mellitus, smoking, but related to the survival time. The shorter the survival time was the more ratio of same circulation loci happened. The longer the survival time was the more ratio of different circulation loci happened. 37% of cases with recurrent strokes happened in the first year occupied the most cases in the 5 years. Conclusions With the long time study of the location of recurrent stroke, we get the conclusion that the longer the survival time is the more ra- tio of different circulation stroke happen. So we emphasize the importance of medicine for the stroke in long time. At the same time we conclude the rationality of endovascular treatments within 1 year from first stroke because recurrent loci is more often in the same circulation in 1 year.