目的    探索免疫联合靶向治疗对原发性肝癌病人发生远期脑卒中的影响。方法    回顾性分析2016年1月至2018年12月西安交通大学第一附属医院肝胆外科134例原发性肝癌病人临床资料，采用单因素及多因素Cox回归筛选出影响原发性肝癌病人发生远期脑卒中的相关危险因素，采用倾向性评分匹配对独立危险因素和组间差异因素进行匹配， Kaplan-Meier法对相关危险因素的脑卒中发生率进行估计，绘制生存曲线并进行统计学检验。 结果    多因素Cox回归分析发现年龄、免疫靶向联合治疗是肝癌病人发生远期脑卒的独立危险因素（P＜0.05），Kaplan-Meier预后分析显示在匹配前后免疫靶向联合治疗均是肝癌病人发生远期脑卒的重要风险因素，匹配前风险比为9.1、匹配后风险比为11.8（均P＜0.05）。 结论    免疫联合靶向治疗的肝癌病人发生远期脑卒中的风险增加。

Analysis of the risk of long-term stroke in patients with hepatocellular carcinoma treated with immune-targeted combination therapy        YANG Kun* , LONG Yun-xiang , LIU Tong ,et al. *Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China；School of the Future Technology, Xi’an Jiaotong University,Xi’an 710049,China
Corresponding authors: QU Kai, E-mail: joanne8601@163.com; LI Guo-liang, E-mail: liguoliang_med@163.com; LIU Chang, E-mail: eyrechang@126.com 
Abstract    Objective    To analyze the risk of long-term stroke during immunotherapy combined with targeted therapy in patients with primary liver cancer. Methods    The clinical data of 134 patients with primary hepatocellular carcinoma in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to December 2018 were retrospectively analyzed. Univariate and multivariate Cox regression was used to screen out the related risk factors for long-term stroke in patients with primary liver cancer, and propensity score matching was used to match independent risk factors and factors that differed between groups, Kaplan-Meier method was used to estimate the incidence of stroke among the target risk factors, and survival curves were plotted and statistically tested. Results  Multivariate Cox regression analysis showed that age and immunotherapy combined with targeted therapy were independent risk factors for long-term stroke in patients with liver cancer (P < 0.05). Kaplan-Meier prognostic analysis showed that immunotherapy combined with targeted therapy was an important risk factor for long-term stroke in patients with primary hepatocellular carcinoma before and after matching; the hazard ratio was 9.1 before matching and 11.8 after matching (all P<0.05). Conclusion    Immunotherapy combined with targeted therapy increases the risk of long-term stroke in primary hepatocellular carcinoma patients.