目的：探讨嗜酸性肉芽肿性多血管炎（Eosinophilic Granulomatosis with Polyangiitis，EGPA）患者并发 缺血性卒中的临床特征及潜在危险因素。方法：回顾性选择2015年1月～2025年12月于我院确诊的EGPA患者76例纳入EGPA组，再根据是否并发缺血性卒中分为卒中亚组（8例）和非卒中亚组（68例）。收集 患者的基线临床数据、伯明翰血管炎活动度评分（Birmingham Vasculitis Activity Score，BVAS）及脏器受累 情况，并以同期220例健康体检者为对照（对照组）。鉴于阳性结局事件数限制，采用单因素分析、Spearman 相关性分析及高危表型重叠分析探讨EGPA患者并发缺血性卒中的危险因素。结果：76例EGPA患者中， 缺血性卒中发生率为 10.52%。与非卒中亚组相比，卒中亚组基线疾病活动度显著增高（BVAS 中位数 45.00 v.s. 5.00分，P=0.003），抗中性粒细胞胞浆抗体（Antineutrophil Cytoplasmic Antibodies，ANCA）阳性率 （50.0% v.s. 8.8%，P=0.047）及髓过氧化物酶（myeloperoxidase，MPO）-ANCA滴度（P=0.010）显著升高，且心 脏受累比例极高（50.0% v.s. 0，P=0.021）。相关性分析显示，BVAS评分是连接免疫学表型（MPO滴度）与靶 器官损伤（心脏受累）的核心因素。高危表型重叠分析提示，缺血性卒中的发生存在高度异质性，37.5%的 患者表现为高BVAS、ANCA阳性与心脏受累的“三重叠加”。结论：极高的系统性炎症负荷（BVAS）、ANCA阳性表型以及合并心脏受累是EGPA并发缺血性卒中的核心预警信号。临床应警惕该类高危亚群，及 时开展心脑血管靶向筛查。

To investigate the clinical characteristics and potential risk factors for concurrent ischemic stroke in patients with eosinophilic granulomatosis with polyangiitis (EGPA). Methods: A retrospective selection was conducted on 76 EGPA patients diagnosed at our hospital between January 2015 and December 2025, who were enrolled in the EGPA group. These patients were further divided into a stroke subgroup (8 cases) and a non-stroke subgroup (68 cases) based on the occurrence of concurrent ischemic stroke. Baseline clinical data, the Birmingham Vasculitis Activity Score (BVAS), and organ involvement were collected. Additionally, 220 healthy examinees from the same period served as controls (control group). Given the limited number of positive outcome events, univariate analysis, Spearman correlation analysis, and high-risk phenotype overlap analysis were employed to explore the risk factors for ischemic stroke in EGPA patients. Results: Among the 76 EGPA patients, the incidence of ischemic stroke was 10.52% . Compared with the non-stroke subgroup, the stroke subgroup exhibited significantly higher baseline disease activity (median BVAS: 45.00 v.s. 5.00, P=0.003), a significantly higher positive rate of Antineutrophil Cytoplasmic Antibodies (ANCA) (50.0% v.s. 8.8%, P=0.047), and elevated myeloperoxidase (MPO)-ANCA titers (P=0.010), alongside an extremely high proportion of cardiac involvement (50.0% v.s. 0, P=0.021). Correlation analysis demonstrated that the BVAS was the core factor linking the immunological phenotype (MPO titer) with target organ damage (cardiac involvement). High-risk phenotype overlap analysis indicated a high degree of heterogeneity in the occurrence of ischemic stroke, with 37.5% of patients presenting a "triple overlap" of high BVAS, ANCA positivity, and cardiac involvement. Conclusion: An extremely high systemic inflammatory burden (BVAS), ANCA-positive phenotype, and concurrent cardiac involvement constitute the core warning signals for EGPA complicated by ischemic stroke. Clinically, vigilance should be maintained for this high-risk subgroup, and targeted cardio-cerebrovascular screening should be conducted in a timely manner.