Objective To explore the effect of patients with acute cerebral infarction and complication of acute gastric mucosal lesions (AGML) on their short-term prognoses.Methods Two hundred and sixteen patients with acute cerebral infarction admitted to the Department of Neurology in Tianjin Nankai Hospital from January to December 2014 were enrolled, and they were divided into the control group without AGML (167 cases) and observation group with AGML (49 cases) according to whether AGML occurred or not. The digestive tract was monitored in the two groups, and the relationships between the incidence of AGML and the location of infarction, stroke classification, as well as the anti-thrombosis treatments like thrombolysis, anti-coagulation and anti-platelet, etc. were analyzed; the changes in scores of the National Institutes of Health Stroke Scale (NIHSS) on admission, 7 days and 14 days after onset and 14-day mortality of two groups were compared.Results AGML occurred in 49 of 216 patients (22.69%); the 14-day mortality of the observation group was obviously higher than that of the control group [6.12% (3/48) vs. 1.80% (3/167),P < 0.05], the incidence of infarction located in cerebellum, brainstem, multiple cerebral lobes, etc. (low density shadow > 1/3 hemispheres) in the observation group was higher than that in the control group [cerebellum: 18.37% (9/49) vs. 4.19% (7/167); brainstem: 24.49% (12/49) vs. 8.98% (15/167), multiple lobes: 16.33% (8/49) vs. 2.99% (5/167), all P < 0.05]; the incidence of cardiac cerebral embolism (CE) was significantly higher than that in the control group [55.10% (27/49) vs. 12.57% (21/167),P < 0.05]. With the extension of disease course, the NIHSS score of the observation group was increased, while the score of the control group was gradually reduced, and the NIHSS scores of the observation group were obviously higher than those of control group on the 7th and 14th day after onset (7 days: 18.12±4.20 vs. 10.93±6.73, 14 days: 19.33±3.11 vs. 9.66±9.15, bothP < 0.05). The thrombolysis, argatroban anti-coagulation and anti-platelet incidence between the two groups after treatments was of no statistically significant difference (the incidence in control group was 4.79%, 47.31%, 47.90%, and it was 4.08%, 44.90%, and 48.98% in observation group, allP < 0.05). Conclusion The occurrence of AGML complication in patients with acute cerebral infarction is closely related to their short-term prognoses, and when the cerebral embolus is cardiac in origin or the infarction is located at multiple cerebral lobes, brain stem or cerebellum, the probability of the occurrence of AGML is relatively high, suggesting a poor outcome.%目的：探讨急性脑梗死合并急性胃黏膜病变（AGML）对患者短期预后的影响。方法选择2014年1月至12月天津南开医院神经内科收治的急性脑梗死患者216例，将其按是否发生AGML分为未发生AGML对照组（167例）和发生AGML观察组（49例）。观察两组患者消化道情况，分析是否发生AGML与梗死部位、卒中分型及溶栓、抗凝、抗血小板等抗栓治疗的关系；比较两组患者入组时、发病7 d和14 d美国国立卫生研究院卒中量表（NIHSS）评分的变化和发病14 d病死率。结果216例患者中49例（22.69%）伴发AGML；观察组14 d病死率明显高于对照组〔6.12%（3/48）比1.80%（3/167），P＜0.05〕。观察组小脑、脑干、多脑叶（低密度影＞1/3大脑半球）等部位梗死发生率高于对照组〔小脑：18.37%（9/49）比4.19%（7/167）；脑干：24.49%（12/49）比8.98%（15/167），多脑叶：16.33%（8/49）比2.99%（5/167），均P＜0.05〕；心源性脑栓塞（CE）比例明显高于对照组〔55.10%（27/49）比12.57%（21/167），P＜0.05〕。随着病程的延长，观察组的NIHSS评分逐渐升高，对照组的NIHSS评分逐渐降低，发病后7 d、14 d观察组NIHSS评分明显高于对照组〔7 d（分）：18.12±4.20比10.93±6.73，14 d（分）：19.33±3.11比9.66±9.15，均P＜0.05〕。观察组采用溶栓、阿加曲班抗凝及抗血小板治疗比例与对照组比较差异无统计学意义（对照组分别为4.79%、47.31%、47.90%，观察组分别为4.08%、44.90%、48.98%，均P＞0.05）。结论急性脑梗死合并AGML与短期预后密切相关，CE、多脑叶、脑干、小脑梗死患者出现AGML的概率较高，提示预后不良。
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