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Article(id=1322931433253249192, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.13.014, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1761235200000, receivedDateStr=2025-10-24, revisedDate=1778774400000, revisedDateStr=2026-05-15, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341032564, onlineDateStr=2026-10-30, pubDate=1783612800000, pubDateStr=2026-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341032564, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341032564, creator=13701087609, updateTime=1793341032564, updator=13701087609, issue=Issue{id=1322931411006665649, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='13', pageStart='2193', pageEnd='2384', issueExtLink='null', onlineDate='null', pubDate='1783612800000', pubDateStr='2026-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341027261, creator='13701087609', updateTime=1793343114456, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940165425082661, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940165425082662, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2293, endPage=2297, ext={EN=ArticleExt(id=1322931433458770089, articleId=1322931433253249192, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Association between dietary diversity and risk of stroke among Chinese older adults, columnId=1220689484526572183, journalTitle=Chinese Nursing Research, columnName=Original Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the association between dietary diversity and the risk of stroke among Chinese older adults.

Methods

Based on data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS),a total of 10 402 older adults were included in this study.Differences in dietary and general characteristics between groups with different stroke statuses were compared.Logistic regression was used to analyze the association between dietary diversity and stroke risk,followed by subgroup analyses.

Results

Chang scores of dietary diversity was negatively associated with the risk of stroke[OR=0.950,95%CI(0.913,0.988),P=0.010].The protective association was more pronounced among females,individuals aged ≥80 years,rural residents,and those with low education levels.

Conclusions

Improving dietary diversity may reduce the risk of stroke in older adults.Nursing staff should incorporate dietary diversity guidance into chronic disease management for the elderly and provide individualized dietary nursing interventions.

, authors=Guangying WANG, Wenyuan MA, Qian ZHUANG, Xingyan MEI, Xiaoming ZHENG, authorsList=Guangying WANG, Wenyuan MA, Qian ZHUANG, Xingyan MEI, Xiaoming ZHENG, authorCompany=null, correspAuthors=Wenyuan MA, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931434205356206, articleId=1322931433253249192, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=中国老年人膳食多样性与脑卒中发生风险的关联性, columnId=1220689484681761433, journalTitle=护理研究, columnName=科研论著, runingTitle=null, highlight=null, articleAbstract=
目的

探讨中国老年人群膳食多样性与脑卒中发生风险的关联性。

方法

基于中国老年健康影响因素跟踪调查（CLHLS）数据，纳入10 402名老年人为研究对象。比较不同脑卒中患病状态人群的膳食及一般资料差异，采用Logistic回归分析膳食多样性与脑卒中发生风险的关联，并进行亚组分析。

结果

膳食多样性变化得分对脑卒中发生风险有影响［OR=0.950，95%CI（0.913，0.988），P=0.010］；在女性、≥80岁、农村居住、低教育水平人群中，保护性关联更突出。

结论

提高膳食多样性可降低老年人脑卒中发生风险，护理人员应将膳食多样性指导纳入老年慢性病管理，为老年人提供个体化饮食护理干预。

, authors=王广英, 马文元*, *, 庄倩, 梅兴燕, 郑晓明, authorsList=王广英, 马文元, 庄倩, 梅兴燕, 郑晓明, authorCompany=null, correspAuthors=马文元, authorNote=

王广英,副主任护师,本科

, correspAuthorsNote=
马文元，E-mail：
MA Wenyuan, E-mail:
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王广英,副主任护师,本科

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王广英,副主任护师,本科

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Q, Xie M J, journalName=Scientific Reports, refType=null, unstructuredReference=Wen X Y,Wu Q,Xie M J,et al.Education and stroke:evidence from epidemiology and Mendelian randomization study[J].Scientific Reports,2020,10:21208., articleTitle=Education and stroke:evidence from epidemiology and Mendelian randomization study, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322931434436042927, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, xref=1, ext=[AuthorCompanyExt(id=1322931434444431536, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, companyId=1322931434436042927, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Linyi People's Hospital, Shandong 276000 China), AuthorCompanyExt(id=1322931434461208753, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, companyId=1322931434436042927, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1临沂市人民医院，山东 276000)])], figs=[ArticleFig(id=1322931440064798933, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=EN, label=Figure 1, caption=Flowchart of study participant selection, figureFileSmall=BlcVDbWcJALkJieOyK5Z0Q==, figureFileBig=GPvYKFoDhSzbXi6Xaj9nWQ==, tableContent=null), ArticleFig(id=1322931440152879318, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=CN, label=图1, caption=研究对象筛选流程图, figureFileSmall=BlcVDbWcJALkJieOyK5Z0Q==, figureFileBig=GPvYKFoDhSzbXi6Xaj9nWQ==, tableContent=null), ArticleFig(id=1322931441943847129, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=EN, label=Figure 2, caption=Subgroup analysis of the effect of dietary diversity on stroke incidence in older adults, figureFileSmall=ZpPPX4lKwweJrc4JKD2Isg==, figureFileBig=JPJERzJUVEFlF42vTdjKNA==, tableContent=null), ArticleFig(id=1322931442036121818, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=CN, label=图2, caption=膳食多样性对老年人脑卒中发生影响的亚组分析, figureFileSmall=ZpPPX4lKwweJrc4JKD2Isg==, figureFileBig=JPJERzJUVEFlF42vTdjKNA==, tableContent=null), ArticleFig(id=1322931442107424987, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=EN, label=Table 1, caption=

Comparison of general characteristics between older adults with and without stroke

, figureFileSmall=null, figureFileBig=null, tableContent=
变量发生组（n=1 267）未发生组（n=9 135）统计值P
膳食变化（分）0.028±1.5520.288±1.605t=-5.561<0.001
主食摄入量（两）5.012±3.8675.236±4.374t=-1.7300.084
膳食变化[人（%）]下降335（26.4）1 967（21.5）
不变602（47.5）4 206（46.0）χ2=26.938<0.001
上升330（26.0）2 962（32.4）
性别[人（%）]男611（48.2）3 909（42.8）χ2=13.365<0.001
女656（51.8）5 226（57.2）
居住地[人（%）]城市530（41.8）2 040（22.3）
城镇331（26.1）3 133（34.3）χ2=227.548<0.001
农村406（32.0）3 962（43.4）
婚姻状况[人（%）]已婚(与配偶居住)579（45.7）3 575（39.1）χ2=19.982<0.001
其他688（54.3）5 560（60.9）
居住方式[人（%）]与家人1 018（80.3）7 420（81.2）χ2=0.5610.454
独居或养老院249（19.7）1 715（18.8）
主食[人（%）]大米682（53.8）5 431（59.5）χ2=19.059<0.001
面食227（17.9）1 554（17.0）
米面297（23.4）1 715（18.8）
其他61（4.8）435（4.8）
食用油[人（%）]植物油1 223（96.5）8 205（89.8）χ2=58.992<0.001
动物油44（3.5）930（10.2）
现在抽烟[人（%）]不抽1 131（89.3）7 763（85.0）χ2=16.483<0.001
抽136（10.7）1 372（15.0）
过去抽烟[人（%）]不抽868（68.5）6 488（71.0）χ2=3.3990.065
抽399（31.5）2 647（29.0）
过去饮酒[人（%）]不喝963（76.0）6 854（75.0）χ2=0.5680.451
喝304（24.0）2 281（25.0）
现在饮酒[人（%）]不喝1 147（90.5）7 761（85.0）χ2=28.065<0.001
喝120（9.5）1 374（15.0）
水果[人（%）]经常吃655（51.7）4 169（45.6）χ2=16.427<0.001
不常吃612（48.3）4 966（54.4）
蔬菜[人（%）]经常吃1 092（86.2）8 084（88.5）χ2=5.6960.017
不常吃175（13.8）1 051（11.5）
年龄[人（%）]<80岁462（36.5）3 215（35.2）χ2=0.7850.376
≥80岁805（63.5）5 920（64.8）
教育年限[人（%）]<1年526（41.5）4 573（50.1）
1~<7年369（29.1）2 946（32.2）χ2=99.279<0.001
≥7年372（29.4）1 616（17.7）
口味[人（%）]清淡833（65.7）6 361（69.6）
咸268（21.2）1 736（19.0）χ2=8.0040.018
其他166（13.1）1 038（11.4）
), ArticleFig(id=1322931442208088284, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=CN, label=表1, caption=

脑卒中发生与未发生的老年人一般资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
变量发生组（n=1 267）未发生组（n=9 135）统计值P
膳食变化（分）0.028±1.5520.288±1.605t=-5.561<0.001
主食摄入量（两）5.012±3.8675.236±4.374t=-1.7300.084
膳食变化[人（%）]下降335（26.4）1 967（21.5）
不变602（47.5）4 206（46.0）χ2=26.938<0.001
上升330（26.0）2 962（32.4）
性别[人（%）]男611（48.2）3 909（42.8）χ2=13.365<0.001
女656（51.8）5 226（57.2）
居住地[人（%）]城市530（41.8）2 040（22.3）
城镇331（26.1）3 133（34.3）χ2=227.548<0.001
农村406（32.0）3 962（43.4）
婚姻状况[人（%）]已婚(与配偶居住)579（45.7）3 575（39.1）χ2=19.982<0.001
其他688（54.3）5 560（60.9）
居住方式[人（%）]与家人1 018（80.3）7 420（81.2）χ2=0.5610.454
独居或养老院249（19.7）1 715（18.8）
主食[人（%）]大米682（53.8）5 431（59.5）χ2=19.059<0.001
面食227（17.9）1 554（17.0）
米面297（23.4）1 715（18.8）
其他61（4.8）435（4.8）
食用油[人（%）]植物油1 223（96.5）8 205（89.8）χ2=58.992<0.001
动物油44（3.5）930（10.2）
现在抽烟[人（%）]不抽1 131（89.3）7 763（85.0）χ2=16.483<0.001
抽136（10.7）1 372（15.0）
过去抽烟[人（%）]不抽868（68.5）6 488（71.0）χ2=3.3990.065
抽399（31.5）2 647（29.0）
过去饮酒[人（%）]不喝963（76.0）6 854（75.0）χ2=0.5680.451
喝304（24.0）2 281（25.0）
现在饮酒[人（%）]不喝1 147（90.5）7 761（85.0）χ2=28.065<0.001
喝120（9.5）1 374（15.0）
水果[人（%）]经常吃655（51.7）4 169（45.6）χ2=16.427<0.001
不常吃612（48.3）4 966（54.4）
蔬菜[人（%）]经常吃1 092（86.2）8 084（88.5）χ2=5.6960.017
不常吃175（13.8）1 051（11.5）
年龄[人（%）]<80岁462（36.5）3 215（35.2）χ2=0.7850.376
≥80岁805（63.5）5 920（64.8）
教育年限[人（%）]<1年526（41.5）4 573（50.1）
1~<7年369（29.1）2 946（32.2）χ2=99.279<0.001
≥7年372（29.4）1 616（17.7）
口味[人（%）]清淡833（65.7）6 361（69.6）
咸268（21.2）1 736（19.0）χ2=8.0040.018
其他166（13.1）1 038（11.4）
), ArticleFig(id=1322931442304557277, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=EN, label=Table 2, caption=

Logistic regression analysis of the effect of dietary diversity on stroke incidence in older adults

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
OR值95%CIPOR值95%CIP
膳食多样性变化得分0.902[0.869，0.936]<0.0010.918[0.884，0.953]<0.001
膳食多样性变化类型下降1.0001.000
不变0.840[0.728，0.970]0.0180.865[0.748，1.000]0.050
提高0.654[0.556，0.769]<0.0010.705[0.599，0.831]<0.001
变量模型3模型4
OR值95%CIPOR值95%CIP
膳食多样性变化得分0.938[0.902，0.975]0.0010.950[0.913，0.988]0.010
膳食多样性变化类型下降1.0001.000
不变0.813[0.702，0.942]0.0060.838[0.723，0.971]0.019
提高0.759[0.643，0.896]0.0010.798[0.675，0.943]0.008
), ArticleFig(id=1322931442392637664, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931433253249192, language=CN, label=表2, caption=

膳食多样性对老年人脑卒中发生影响的Logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2
OR值95%CIPOR值95%CIP
膳食多样性变化得分0.902[0.869，0.936]<0.0010.918[0.884，0.953]<0.001
膳食多样性变化类型下降1.0001.000
不变0.840[0.728，0.970]0.0180.865[0.748，1.000]0.050
提高0.654[0.556，0.769]<0.0010.705[0.599，0.831]<0.001
变量模型3模型4
OR值95%CIPOR值95%CIP
膳食多样性变化得分0.938[0.902，0.975]0.0010.950[0.913，0.988]0.010
膳食多样性变化类型下降1.0001.000
不变0.813[0.702，0.942]0.0060.838[0.723，0.971]0.019
提高0.759[0.643，0.896]0.0010.798[0.675，0.943]0.008
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中国老年人膳食多样性与脑卒中发生风险的关联性
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王广英 , 马文元 *, * , 庄倩 , 梅兴燕 , 郑晓明
护理研究 | 科研论著 2026,40(13): 2293-2297
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护理研究 |科研论著 2026 , 40 (13) : 2293 -2297
中国老年人膳食多样性与脑卒中发生风险的关联性
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王广英, 马文元*, * , 庄倩, 梅兴燕, 郑晓明
作者信息
  • 1临沂市人民医院，山东 276000
通讯作者:
马文元，E-mail：
MA Wenyuan, E-mail:
作者简介:

王广英,副主任护师,本科

Association between dietary diversity and risk of stroke among Chinese older adults
Guangying WANG, Wenyuan MA , Qian ZHUANG, Xingyan MEI, Xiaoming ZHENG
Affiliations
  • 1Linyi People's Hospital, Shandong 276000 China
出版时间: 2026-07-10 doi: 10.12102/j.issn.1009-6493.2026.13.014
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摘要
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目的

探讨中国老年人群膳食多样性与脑卒中发生风险的关联性。

方法

基于中国老年健康影响因素跟踪调查（CLHLS）数据，纳入10 402名老年人为研究对象。比较不同脑卒中患病状态人群的膳食及一般资料差异，采用Logistic回归分析膳食多样性与脑卒中发生风险的关联，并进行亚组分析。

结果

膳食多样性变化得分对脑卒中发生风险有影响［OR=0.950，95%CI（0.913，0.988），P=0.010］；在女性、≥80岁、农村居住、低教育水平人群中，保护性关联更突出。

结论

提高膳食多样性可降低老年人脑卒中发生风险，护理人员应将膳食多样性指导纳入老年慢性病管理，为老年人提供个体化饮食护理干预。

老年人  /  膳食多样性  /  脑卒中  /  相关性  /  影响因素
Objective

To investigate the association between dietary diversity and the risk of stroke among Chinese older adults.

Methods

Based on data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS),a total of 10 402 older adults were included in this study.Differences in dietary and general characteristics between groups with different stroke statuses were compared.Logistic regression was used to analyze the association between dietary diversity and stroke risk,followed by subgroup analyses.

Results

Chang scores of dietary diversity was negatively associated with the risk of stroke[OR=0.950,95%CI(0.913,0.988),P=0.010].The protective association was more pronounced among females,individuals aged ≥80 years,rural residents,and those with low education levels.

Conclusions

Improving dietary diversity may reduce the risk of stroke in older adults.Nursing staff should incorporate dietary diversity guidance into chronic disease management for the elderly and provide individualized dietary nursing interventions.

older adults  /  dietary diversity  /  stroke  /  association  /  influencing factors
王广英, 马文元, 庄倩, 梅兴燕, 郑晓明. 中国老年人膳食多样性与脑卒中发生风险的关联性. 护理研究, 2026 , 40 (13) : 2293 -2297 . DOI: 10.12102/j.issn.1009-6493.2026.13.014
Guangying WANG, Wenyuan MA, Qian ZHUANG, Xingyan MEI, Xiaoming ZHENG. Association between dietary diversity and risk of stroke among Chinese older adults[J]. Chinese Nursing Research, 2026 , 40 (13) : 2293 -2297 . DOI: 10.12102/j.issn.1009-6493.2026.13.014
正文
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脑卒中作为一种慢性非传染性疾病，已成为死亡和残疾的主要原因，其对人民群众的健康构成重大威胁[1]。2019年全球疾病负担研究显示，全球脑卒中年发病人数为1 220万例，死亡人数为655万例，中国分别为394万例和219万例[2]。脑卒中不仅对病人的生活质量造成影响，而且给整个家庭和社会带来沉重的负担[3]。随着人口规模和预期寿命的持续增长，中国也成为世界上老龄人口最多的国家，也是当今世界上老龄化速度最快的国家之一，到2065年，中国将成为世界上人口最多的20个国家中老龄化最严重的国家[4]。预计到2050年，脑卒中负担在卒中事件中增加81%，相当于首次脑卒中病人增加962万例[5]。在此趋势下，疾病负担越来越重，且呈上升趋势[6]。脑卒中作为一种可控可预防的疾病，可以通过早期筛查干预改善病人的预后[1]。通过改变饮食因素进行疾病的一级预防在一些疾病中已经得到验证[7-8]，不良的饮食因素也会增加疾病的发病风险[9]。本研究基于国内长期纵向研究数据，探讨膳食因素对脑卒中发病风险的影响，以期为制定脑卒中饮食的一级预防提供参考。
1　对象与方法
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1.1　研究对象
中国老年健康影响因素跟踪调查（Chinese Longitudinal Healthy Longevity Survey,CLHLS）[10]自1998年开始每2~3年进行1次调查，到目前为止共进行了8次调查，涉及11.3万人。CLHLS项目在全国23个省、自治区、直辖市随机抽取大约一半县市的65岁以上人群进行跟踪调查。项目已获北京大学伦理委员会批准(IRB00001052-13074)。此本研究采用CLHLS项目组2018年的数据，共涉及15 874名老年人。纳入标准：具有完整的人口学资料以及所需的健康资料。所有参与者都签署基线和随访调查的知情同意书。研究对象筛选流程见图1。
1.2　观察指标
1.2.1　一般资料
包括性别、年龄、居住地、居住情况、受教育年限、婚姻状况、吸烟、饮酒等。将所有回答中回答“不知道”计为缺失值。
1.2.2　膳食多样性
使用CLHLS调查中涉及的水果、蔬菜、肉类、鱼等水产品、蛋类、豆制品、腌咸菜或泡菜、糖类、奶制品、坚果、菌藻类、大蒜、茶等。如果被调查者回答“每天/几乎每天吃”“经常吃”“不是每天，但每周至少吃1次”计为1分，否则计为0分。将13种食物得分相加衡量饮食多样性，分数越高代表饮食类型越丰富[7]。
1.2.3　膳食多样性变化情况
使用被调查者在目前和60岁时的膳食多样性得分之差描述，膳食多样性水平分为提高、不变或下降3类。
1.2.4　脑卒中患病情况
使用问题“您现在是否患有下列慢性疾病？”评估。
1.3　统计学方法
采用SPSS 23.0和R4.2.2进行统计分析。符合正态分布的定量资料使用均数±标准差（x±s）描述；定性资料使用频数、百分比（%）描述。比较采用独立样本t检验或χ2检验，采用Logistic回归分析膳食因素与脑卒中发病的关联性，并建立了4个回归模型。模型1：未调整其他变量；模型2：调整生活方式变量（主食、食用油、现在抽烟、现在饮酒、口味、水果、蔬菜）；模型3：调整人口学变量（性别、居住地、婚姻状况、教育年限分类、年龄）；模型4：将所有变量纳入。为探讨关联在不同人群中的异质性，对模型3进行亚组分析。以P<0.05为差异有统计学意义。
2　结果
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2.1　研究对象的基本特征
共纳入10 402人，其中男4 520人，女5 882人；<80岁3 677人，≥80岁6 725人；居住地为城市2 570人，城镇3 464人，农村4 368人；已婚且与配偶共同生活4 154人，与家人一起居住8 438人。脑卒中患病率为12.2%。结果显示，膳食变化、性别、居住地、婚姻状况、主食、食用油、口味、抽烟、饮酒、水果、蔬菜、教育年限对脑卒中发生风险有影响（P<0.05）。见表1。
2.2　膳食多样性对老年人脑卒中发生风险影响的Logistic回归分析
以是否存在脑卒中(否=0，是=1)为因变量，以膳食变化得分分别作为连续型变量和分类变量（将膳食多样性变化下降作为参照）以及其他变量作为控制变量，建立4个Logistic回归模型。不论膳食多样性作为连续变量还是分类变量时，在模型1~模型4中，OR值均<1，膳食多样性水平的增高是脑卒中发病风险的保护因素。在4个模型当中，对纳入模型的连续自变量进行方差膨胀因子（VIF）诊断，所有变量VIF均<1.6，提示不存在严重共线性。Logistic回归分析结果见表2。
2.3　膳食多样性对老年人脑卒中发生影响的亚组分析
对模型3进行亚组分析，其中女性、年龄≥80岁、居住地为农村、婚姻状况为其他、受教育程度<1年是脑卒中发生的保护因素（P<0.05）。见图2。
3　讨论
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目前，饮食作为一级预防措施预防慢性病的发生受到越来越广泛的关注[7-8]。本研究基于全国老年代表性样本发现，膳食多样性水平较高的老年人，与较低的脑卒中发生风险存在关联。Harshfield等[11]的研究发现，通过改变生活方式可以降低脑卒中的发生率。在本研究中，未发生脑卒中的老年人膳食多样性增长幅度高于发生组。在控制了协变量的4次回归分析中均有统计学意义，说明提高膳食多样性与中国老年人脑卒中发生风险呈负相关。本研究结果支持膳食多样性在脑血管健康促进中的作用，随着社会经济的快速发展，我国居民的饮食种类越来越丰富，多样性水平的饮食通常意味着更均衡的营养，而健康饮食会对脑血管起保护性作用[8]。不健康的饮食则会适得其反，比如长期摄入过量的钠可导致高血压、心血管疾病和脑卒中的发生[12-13]。这提示膳食多样性水平的提升能降低脑卒中发生率。Logistic回归分析结果也支持这一观点，从模型1到模型4，随着纳入的变量增多，不论将膳食变化水平作为连续变量还是分类变量，OR值均<1，提示膳食多样化水平的提高与脑卒中的发生存在负相关。当膳食多样性作为分类变量时，不论纳入的变量是否增加，OR均随着膳食水平的提高而下降。以往的研究也指出健康的饮食习惯能够降低脑卒中发生的风险[1,8]。
中国是最大的发展中国家，人口约占世界总人口的1/5，脑卒中病人数量居世界首位[1]。本研究结果显显示，脑卒中患病率为12.2%，这与以往的研究[14]一致。其中男性老年人脑卒中发病率高于女性[15]，并且男性的发病趋势逐年上升，而女性的发病率趋于稳定[1]，这可能与男性有吸烟、饮酒等不良习惯有关，因此，男性应更注意生活习惯，以预防脑卒中的发生。本研究亚组分析结果显示，女性与脑卒中发生呈负相关，而男性组未观察到具有统计学意义的关联，分析其原因可能由于女性的平均寿命长于男性[16]，并且女性发生脑卒中时的年龄往往比男性年龄大[17]。一方面由于CLHLS项目中年龄大的老年人纳入较多，年龄大于80岁参与者占64.7%，且本研究中纳入的男性（43.5%）相对少于女性，所以未显示出男性与卒中发生的关联。亚组分析还显示居住地为农村、受教育程度<1年与脑卒中发生呈负相关。2024中国脑卒中防治报告指出，我国农村与城镇地区脑卒中患病率趋势逐年变动，仍需长期调查，而农村地区空气环境相对较好，空气颗粒污染物低[18]，可能是脑卒中发生率低的因素之一[19]，从而出现本研究中农村亚组的脑卒中发生率低的情况。本研究亚组分析中，受教育程度<1年与脑卒中发生呈负相关，这与以往的研究得出受教育程度与脑卒中的发生成负相关关系[20]相悖，但在本研究中纳入的80岁人群占比较大，这与Wen等[20]的研究不同，并且由于问卷调查本身的偏倚，加上被调查者年龄过大，可能对于受教育年限的记忆存在误差。
4　小结
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脑卒中是一种可预防、可控的疾病，早期筛查和积极干预可改善疾病预后。本研究显示，随着老年人膳食多样性水平的增加，有利于降低老年人脑卒中的发病风险，可以鼓励老年人在自身能力范围内增加膳食多样性。本研究的局限性：横断面研究无法进行统计因果推断；膳食多样性变化的评估和是否患有脑卒中均基于病人的回忆，存在一定的回忆偏倚。研究结论仍然需要未来进行前瞻性研究来验证。

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2026年第40卷第13期
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doi: 10.12102/j.issn.1009-6493.2026.13.014
  • 接收时间：2025-10-24
  • 首发时间：2026-10-30
  • 出版时间：2026-07-10
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  • 收稿日期：2025-10-24
  • 修回日期：2026-05-15
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    1临沂市人民医院，山东 276000

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马文元，E-mail：
MA Wenyuan, E-mail:
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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