目的：探讨肺癌患者肺叶切除术后发生脑梗死的危险因素。方法：连续收集并前瞻性登记2016年11 月至2018年11月于郑州大学第一附属医院接受肺叶切除术的肺癌患者708例，术后随访6个月。根据在随 访期间是否发生脑梗死，患者分为脑梗死组和对照组；收集2组的临床资料分别进行单因素分析和多因素 Logistic回归分析。结果：纳入脑梗死组12例（1.7%），对照组696例（98.3%）。单因素分析显示：脑梗死组 糖尿病和高脂血症患者的比例高于对照组（P＜0.05）；2组的病灶切除部位、手术方式差异有统计学意义 （P＜0.05），其他指标差异无统计学意义（P＞0.05）。多因素Logistic分析显示：在调整了年龄、性别、吸烟 史、高血压、房颤、冠心病、术后抗凝治疗、手术持续时间和住院时长后，左上肺叶切除术（OR=10.670，95% CI 2.021～56.325，P=0.005）、左全肺切除术（OR=13.726，95%CI 1.398～134.746，P=0.025），糖尿病（OR= 6.021，95%CI 1.483～24.436，P=0.012）和高脂血症（OR=6.786，95% CI 1.337～34.455，P=0.021）与肺癌患者 术后发生脑梗死独立相关。结论：左上肺叶切除术、左全肺切除术、糖尿病病史和高脂血症病史可能是肺 癌患者肺叶切除术后发生脑梗死的独立危险因素。

To investigate the risk factors of cerebral infarction in patients with lung cancer after pulmonary lobectomy. Methods: A total of 708 consecutive patients with lung cancer who underwent pulmonary lobectomy at the First Affiliated Hospital of Zhengzhou University from November 2016 and November 2018 were prospective registered and followed up for 6 months. According to whether complicated by postoperative cerebral infarction, the patients were classified into the cerebral infarction group or control group. Clinical data was collected, and single factor analysis and multi-factor Logistic regression analysis were performed to determine independent predictors for postoperative stroke. Results: Twelve cases (1.7%) were included in the cerebral infarction group and 696 cases (98.3%) in the control group. The cerebral infarction group showed a greater proportion of patients with diabetes mellitus and hyperlipidemia compared to the control group (P<0.05). There were significant differences between the two groups in resection site and surgical method (P<0.05). Other factors showed no significant difference (P>0.05). Multivariate Logistic regression analysis adjusted for age, gender, history of smoking, hypertension, atrial fibrillation, coronary heart disease, postoperative anticoagulation therapy, surgery length, and hospitalization time showed that left upper lobectomy (OR=10.670, 95% CI: 2.021-56.325, P=0.005), left pneumonectomy (OR=13.726, 95% CI: 1.398-134.746, P=0.025), diabetes mellitus (OR=6.021, 95% CI: 1.483-24.436, P=0.012), and hyperlipidemia (OR=6.786, 95% CI: 1.337-34.455, P=0.021) were independent predictors of postoperative cerebral infarction. Conclusion: Left upper lobectomy, left pneumonectomy, diabetes, and hyperlipidemia may be significant risk factors for postoperative cerebral infarction in patients with lung cancer.