目的：探讨优势半球卒中失语症患者二次卒中（RS）后失语商（AQ）与大脑脚形态学变化相关性。 方法：回顾性分析优势半球首次卒中（FS）后合并失语症的RS患者40例的临床资料。根据RS与FS的侧 别关系将患者分为同侧卒中组19例与对侧卒中组21例，分析2组患者的一般情况、RS前后AQ变化及其 与大脑脚非对称比例（CPAR）的关系。结果：2组患者的年龄、性别、病程，合并高血压、高脂血症、糖尿病、 心脏病，不良习惯，卒中类型，语言康复情况差异均无统计学意义（P＞0.05）。缺血性RS患者的AQ高于 出血性患者（P＜0.05）。对侧卒中组RS后AQ值明显低于RS前（P＜0.01）及同侧卒中组（P＜0.01）；对侧 卒中组RS前后AQ变化值显著高于同侧卒中组（P＜0.01）。同侧卒中组和对侧卒中组的CPAR差异无统 计学意义（P＞0.05）。CPAR与对侧卒中组RS后AQ显著相关（P＜0.01），与2组患者RS前AQ及同侧卒 中组 RS 后的 AQ 无明显相关（P＞0.05）。结论：优势半球 FS 后失语症患者在对侧 RS 后的 AQ 变化与 CPAR密切相关。

To explore the correlation between morphological changes of cerebral peduncles and aphasia quotient (AQ) after recurrent stroke (RS) in patients with post-dominant hemisphere stroke aphasia (PSA). Methods: The clinical data of 40 patients with RS and also PSA after first-time stroke (FS) were analyzed retrospectively. According to the side of RS onset, they were divided into the ipsilateral stroke group (n= 19) and contralateral stroke group (n=21), and the demographic characteristic, difference in AQ before and after RS, and the correlation between AQ and cerebral peduncle asymmetry rate (CPAR) was analyzed. Re? sults: There was no significant difference in age; gender; course of disease, comorbidities of hypertension, hyperlipidemia, diabetes, and heart disease; unhealthy habits; stroke type; and speech recovery (P>0.05). The AQ of ischemic RS patients was higher than that of hemorrhagic RS patients (P<0.05). In the contralateral stroke group, the post-RS AQ was significantly lower than the pre-RS AQ and the ipsilateral stroke group AQ (P< 0.01). Change of AQ pre- and post-RS in the contralateral stroke group was significantly higher than that in the ipsilateral stroke group (P<0.01). There was no significant difference in CPAR between the contralateral stroke group and ipsilateral stroke group (P>0.05). There existed an apparent correlation between CPAR and the post-RS AQ of the contralateral stroke group (P<0.01) and no apparent correlation between CPAR and the pre-RS AQ of both groups and the post-RS AQ of the ipsilateral stroke group (P>0.05). Conclusion: The changes in AQ after RS in patients with PSA showed a significant association with CPAR.