中文摘要：

目的探讨复发对急性缺血性脑卒中患者出院结局不良的影响。方法采用回归性队列研究方法，连续性纳入2009年6月1日到2012年5月31日内蒙古兴安盟人民医院神经内科的全部急性缺血性脑卒中患者作为研究对象，共计3440例，结局不良定义为出院发生残疾或住院期间死亡。残疾的定义参照脑卒中量表（MRs），评分在MRs≥3定义为残疾。危险因素的分析采用两分类非条件Logistic回归方法，计算比值比（OR）及95％可信区间（95％CI）。结果3440例患者中有结局不良者359例，发生率10．44％，其中复发者为136例，占37．88％。多因素Logistic回归分析结果表明，年龄（OR=1．24，95％CI为1．09～1．41）、体温（OR=1．92，95％CI为1．43～2．57）、高血压（OR=1．73，95％CI为1．33～2．24）、高血糖（OR=1．67，95％CI为1．26～2．20）、甘油三酯（OR=0．41，95％CI为0．27-0．62）、吸烟（OR=1．37，95％CI为1．01～1．85）及复发（OR=1．49，95％CI为1．15～1．95）是预后不良的独立危险因素，脑卒中复发可增加急性缺血性脑卒中患者出院结局不良49％的风险。结论复发是急性缺血性脑卒中预后不良的独立危险因素，在临床工作及脑卒中患者的健康教育中应注重二级预防，减少急性缺血性脑卒中的复发。

英文摘要：

Objective To explore the adverse effects of recurrence of acute ischemic stroke at discharge. Methods Continuously including 3 440 acute ischemic stroke patients from June 1,2009 to May 31, 2012 in Department of Neurology of the People＇s Hospital of Xinganmeng of Inner Mongolia Autonomous Region were esearch objects. Poor outcome was defined as the occurrence of disability or death at discharge. Disability was defined as the Modified Rankin ＇ s Scale （MRs） , when MRs was 3 or more. Binary logistic regression was used to analysis the risk factors, calculated the odds ratios（OR） and 95% confidence interval （95%CI. Results A total of 359（ 10. 44%） patients occurred poor outcomes, of whom 136（37.88%） patients occurred the 4 . recurrence of ischemic stroke. Multiple logistic regression analysis showed that age （OR = 1.24,95% CI 1.09- 1.41 ） ,body temperature（ OR= 1.92,95%CI 1.43-2. 57）, hypertension （ OR= 1.73,95%CI 1.33-2. 24） ,high blood sugar （OR= 1.67,95%CI 1.26-2. 20） ,glycerin trilaurate（ OR=0 41,95%CI0. 27-0. 62） ,smoking （OR = 1.37,95%CI 1.01-1.85） and recurrence（OR= 1.49,95%CI 1.15-1.95） were independent risk factors of poor outcome at discharge. The recurrence of acute ischemic stroke can increase the risk of the occurrence of poor outcome at discharge up to 49%. Conclusion Recurrence is an independent risk factor for the poor outcome of acute ischemic stroke,we should focus on secondary prevention of stroke patients at the clinical work and health education to reduce the recurrence of ischemic stroke.