Article(id=1321170623800398474, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170608034009636, articleNumber=null, orderNo=null, doi=10.11847/zgggws1147324, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1741190400000, receivedDateStr=2025-03-06, revisedDate=1748016000000, revisedDateStr=2025-05-24, acceptedDate=1753372800000, acceptedDateStr=2025-07-25, onlineDate=1792921222877, onlineDateStr=2026-10-25, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921222877, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921222877, creator=13701087609, updateTime=1792921222877, updator=13701087609, issue=Issue{id=1321170608034009636, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='12', pageStart='1409', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='1765296000000', pubDateStr='2025-12-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921219118, creator='13701087609', updateTime=1793011150268, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1321547806687474583, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170608034009636, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1321547806687474584, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170608034009636, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1423, endPage=1428, ext={EN=ArticleExt(id=1321170625570394763, articleId=1321170623800398474, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Differences in life expectancy and healthy life expectancy of the elderly living in different ways in China: an analysis based on CLHLS, columnId=1321170608730264101, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Promoting Healthy Aging and Improving the Quality of Life for the Elderly, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the life expectancy (LE) and healthy life expectancy (HLE) of the elderly living in different ways in China, as well as gender and urban-rural differences, thus providing data support for optimizing the living arrangements and improving the HLE of the elderly in China.

Methods

The data of 4 503 elderly people aged 65 years old and above in 2014 and 2018 of Chinese Longitudinal Healthy Longevity Survey (CLHLS) were collected. The LE, HLE, and HLE/LE ratio of the elderly living alone and living with their families were measured by the micro-simulation method and compared between different genders as well as between urban and rural areas.

Results

The LE of 65–100 elderly living alone and living with their families in China were 20.12–4.72 years and 17.59–4.13 years, respectively. The HLE were 10.12–1.78 years and 9.26–1.70 years, respectively. The HLE/LE were 50.30%–37.71% and 52.24% –41.16 %, respectively. The LE of men living alone and living with their families for 65 years and 100 years old were 14.77–3.59 years, 16.61–4.12 years, respectively. The HLE were 7.04–1.10 years, 9.80–1.68 years, respectively. The HLE/LE were 47.66%–30.64%, 59.00%–40.78%, respectively. The LE of women living alone and living with their families for 65–100 years old were 23.93–5.21 years and 19.09–3.82 years, respectively. The HLE were 12.14–1.78 years and 8.96–1.29 years, respectively. The HLE/LE were 50.73%–34.17% and 46.96%–22.77%, respectively. The LE, HLE, HLE/LE of male elderly living alone and male elderly living with family were lower than those of female elderly. The HLE and HLE/LE of male elderly living with family were higher than those of female elderly. The LE, HLE and HLE/LE of male elderly living alone were lower than those of male elderly living with family. The LE, HLE and HLE/LE of female elderly living alone were higher than those of female elderly living with family. The LE of the elderly living alone in the city and living with their families for 65–100 years were 20.55–5.29 years and 18.52–5.13 years, respectively. The HLE were 10.02–2.85 years and 9.06–3.04 years, respectively. The HLE/LE were 48.76%–53.88% and 48.92–59.26%, respectively. The LE of the elderly living alone in rural areas and living with their families for 65–100 years were 20.13–4.53 years and 17.28–3.71 years, respectively. The HLE were 10.97–1.20 years and 9.67–0.92 years, respectively. The HLE/LE were 54.50%–26.49% and 55.96%–24.80%, respectively. The LE of the urban elderly at all ages was higher than that of the rural elderly. Except that the HLE of the urban elderly aged 65-68 and the elderly aged 65 and 66 living with their families was lower than that of the rural elderly, the HLE of the elderly at other ages was higher than that of the rural elderly. With the increase of age, the HLE/LE of the rural elderly gradually decreased, while the HLE/LE of the urban elderly gradually increased.

Conclusions

The LE and HLE of the elderly living alone are generally higher than those living with their families, while the HLE/LE ratio demonstrates an opposite trend. Female elderly and the elderly living alone in urban areas have higher LE and HLE, while the male elderly living with their families have higher LE and HLE than the male elderly living alone.

, authors=Fei ZHAO1, Ruirui XIE2, Lili DING1, Bingyi WU1, Huiling DONG3, authorsList=Fei ZHAO, Ruirui XIE, Lili DING, Bingyi WU, Huiling DONG, authorCompany=null, correspAuthors=Bingyi WU, Huiling DONG, authorNote=null, correspAuthorsNote=
WU Bingyi, E-mail:
DONG Huiling, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., 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=1321170629991191196, articleId=1321170623800398474, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=中国不同居住方式老年人预期寿命和健康预期寿命差异性分析:基于CLHLS数据库, columnId=1321170608898036263, journalTitle=中国公共卫生, columnName=专题报道——守护老年健康,提升生命质量, runingTitle=null, highlight=null, articleAbstract=
目的

分析中国不同居住方式老年人的预期寿命(LE)和健康预期寿命(HLE)以及性别和城乡差异,为优化我国老年人居住安排、提升其HLE提供数据支持。

方法

收集2014和2018年中国老年健康影响因素跟踪调查(CLHLS)2期4 503名≥65岁老年人相关数据,采用微观仿真法测算老年人在“独居”和“与家人同住”2种居住状态下的LE、HLE和健康余寿占比(HLE/LE),并比较不同性别和城乡的差异。

结果

中国独居和与家人同住65~100岁老年人的LE分别为20.12~4.72年和17.59~4.13年,HLE分别为10.12~1.78年和9.26~1.70年,HLE/LE分别为50.30%~37.71%和52.64%~41.16%。男性独居和与家人同住65~100岁老年人的LE分别为14.77~3.59年和16.61~4.12年,HLE分别为7.04~1.10年和9.80~1.68年,HLE/LE分别为47.66%~30.64%和59.00%~40.78%;女性独居和与家人同住65~100岁老年人的LE分别为23.93~5.21年和19.09~3.82年,HLE分别为12.14~1.78年和8.96~1.29年,HLE/LE分别为50.73%~34.17%和46.94%~22.77%;各年龄男性独居老年人的LE、HLE、HLE/LE和与家人同住男性老年人的LE均低于女性老年人,与家人同住男性老年人的HLE和HLE/LE均高于女性老年人,独居男性老年人的LE、HLE和HLE/LE均低于与家人同住男性老年人,独居女性老年人的LE、HLE和HLE/LE均高于与家人同住女性老年人。城市独居和与家人同住65~100岁老年人的LE分别为20.55~5.29年和18.52~5.13年,HLE分别为10.02~2.85年和9.06~3.04年,HLE/LE分别为48.76%~53.88%和48.92%~59.26%;农村独居和与家人同住65~100岁老年人的LE分别为20.13~4.53年和17.28~3.71年,HLE分别为10.97~1.20年和9.67~0.92年,HLE/LE分别为54.50%~26.49%和55.96%~24.80%;各年龄城市老年人的LE均高于农村老年人,除城市65~68岁独居老年人及65和66岁与家人同住老年人的HLE低于农村老年人外,其他各年龄老年人的HLE均高于农村老年人;随着年龄增长,农村老年人的HLE/LE逐渐下降,而城市老年人的HLE/LE逐渐上升。

结论

中国独居老年人的LE和HLE普遍高于与家人同住老年人,但HLE/LE较低,其中女性和城市独居老年人在LE和HLE上更具优势,而与家人同住男性老年人的LE和HLE均高于独居男性老年人。

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赵菲(2001—),硕士在读,研究方向:社会保障

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吴炳义,E-mail:
董惠玲,E-mail:
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departmentName=null, remark=3山东第二医科大学护理学院,潍坊 261053)])], figs=[ArticleFig(id=1321170639671644878, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=EN, label=Fig.1, caption=Diagram of health state transition, figureFileSmall=uclu+IKSiIaHEZAk8RKmrg==, figureFileBig=1xPDRER/L26OZr7+EntLJQ==, tableContent=null), ArticleFig(id=1321170639759725263, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=CN, label=图1, caption=健康状态转移示意图, figureFileSmall=uclu+IKSiIaHEZAk8RKmrg==, figureFileBig=1xPDRER/L26OZr7+EntLJQ==, tableContent=null), ArticleFig(id=1321170639965246160, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=EN, label=Fig.2, caption=LE of male and female elderly living in different ways in China, figureFileSmall=P2Ko0pK6oLa7gGPfqGonAw==, figureFileBig=F/WOv9q59ylqSRqpJDw2Xw==, tableContent=null), ArticleFig(id=1321170640040743633, 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figureFileSmall=hgCebZ8EM43tPa2klvZebw==, figureFileBig=EhiiCm7Db3McwB6Yzy6lvg==, tableContent=null), ArticleFig(id=1321170640590197464, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=EN, label=Tab.1, caption=

LE, HLE, and HLE/LE ratio of the elderly living in different ways in China

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年龄/岁独居与家人居住
LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%
6520.1210.1250.3017.599.2652.64
6619.469.7049.8517.058.9052.20
6718.839.3149.4416.468.5051.64
6818.178.8848.8715.878.1551.35
6917.558.5048.4315.317.7850.82
7016.958.1448.0214.777.4550.44
7116.347.7647.4914.207.1150.07
7215.717.4147.1713.656.7849.67
7315.157.0846.7313.216.5149.28
7414.626.7846.3712.706.2148.90
7514.056.4445.8412.225.9148.36
7613.546.1545.4211.745.6347.96
7713.015.8645.0411.285.3947.78
7812.515.5844.6010.845.1447.42
7912.035.3244.2210.444.9046.93
8011.525.0643.9210.014.6646.55
8111.054.8143.539.554.4246.28
8210.614.5743.079.174.2145.91
8310.174.3542.778.774.0045.61
849.744.1342.408.413.8045.18
859.313.9342.218.063.6244.91
868.903.7141.697.703.4444.68
878.523.5241.317.393.2944.52
888.173.3440.887.063.1144.05
897.823.2040.926.762.9643.79
907.463.0140.356.462.8243.65
917.142.8640.066.172.6743.27
926.822.7340.035.902.5443.05
936.502.5739.545.642.4142.73
946.212.4539.455.402.3042.59
955.952.3238.995.172.1942.36
965.682.2038.734.932.0741.99
975.422.0938.564.701.9641.70
985.171.9838.304.501.8841.78
994.961.8837.904.311.7941.53
1004.721.7837.714.131.7041.16
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中国不同居住方式老年人LE、HLE和HLE/LE

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄/岁独居与家人居住
LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%
6520.1210.1250.3017.599.2652.64
6619.469.7049.8517.058.9052.20
6718.839.3149.4416.468.5051.64
6818.178.8848.8715.878.1551.35
6917.558.5048.4315.317.7850.82
7016.958.1448.0214.777.4550.44
7116.347.7647.4914.207.1150.07
7215.717.4147.1713.656.7849.67
7315.157.0846.7313.216.5149.28
7414.626.7846.3712.706.2148.90
7514.056.4445.8412.225.9148.36
7613.546.1545.4211.745.6347.96
7713.015.8645.0411.285.3947.78
7812.515.5844.6010.845.1447.42
7912.035.3244.2210.444.9046.93
8011.525.0643.9210.014.6646.55
8111.054.8143.539.554.4246.28
8210.614.5743.079.174.2145.91
8310.174.3542.778.774.0045.61
849.744.1342.408.413.8045.18
859.313.9342.218.063.6244.91
868.903.7141.697.703.4444.68
878.523.5241.317.393.2944.52
888.173.3440.887.063.1144.05
897.823.2040.926.762.9643.79
907.463.0140.356.462.8243.65
917.142.8640.066.172.6743.27
926.822.7340.035.902.5443.05
936.502.5739.545.642.4142.73
946.212.4539.455.402.3042.59
955.952.3238.995.172.1942.36
965.682.2038.734.932.0741.99
975.422.0938.564.701.9641.70
985.171.9838.304.501.8841.78
994.961.8837.904.311.7941.53
1004.721.7837.714.131.7041.16
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LE, HLE, and HLE/LE ratios of male and female elderly living in different ways in China

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄/岁独居老年人与家人同住老年人
男性女性男性女性
LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%
6514.777.0447.6623.9312.1450.7316.619.8059.0019.098.9646.94
6614.316.7347.0323.1211.6250.2616.129.4258.4418.398.5446.44
6713.786.3946.3722.4211.1849.8715.569.0057.8417.788.1645.89
6813.346.1245.8821.6610.7049.4015.088.6557.3617.097.7845.52
6912.845.8345.4020.9010.2248.9014.538.2356.6416.477.4245.05
7012.385.5544.8320.119.7448.4314.027.8756.1315.807.1044.94
7111.935.2744.1719.419.2847.8113.487.4955.5615.176.7344.36
7211.505.0143.5718.748.9047.4913.057.1754.9414.596.4043.87
7311.054.7643.0818.058.4947.0412.556.8154.2613.956.0743.51
7410.624.5242.5617.358.1046.6912.166.5553.8713.405.7843.13
7510.254.3142.0516.727.6845.9311.666.2353.4312.825.4842.75
769.834.0841.5116.077.3145.4911.255.9352.7112.245.1742.24
779.453.8841.0615.426.9645.1410.815.6352.0811.754.9241.87
789.083.6840.5314.786.5744.4510.395.3751.6811.224.6441.35
798.743.4939.9314.186.2544.0810.015.1351.2510.754.4341.21
808.393.3239.5713.585.8943.379.644.8750.5210.254.1640.59
818.033.1338.9813.005.6043.089.264.6350.009.743.9340.35
827.722.9838.6012.495.3242.598.854.3849.499.363.7239.74
837.392.8138.0211.925.0142.038.504.1749.068.913.5339.62
847.112.6837.6911.394.7441.628.153.9548.478.483.3139.03
856.792.5237.1110.904.4841.107.833.7547.898.093.1338.69
866.532.3936.6010.374.2340.797.493.5647.537.702.9538.31
876.242.2636.229.933.9940.187.203.3947.087.312.7838.03
885.972.1335.689.453.7639.796.893.2146.596.972.6237.59
895.742.0335.379.043.5539.276.633.0546.006.642.4837.35
905.481.9134.858.613.3238.566.332.8845.506.302.3236.83
915.251.8234.678.203.1438.296.082.7445.076.012.2036.61
925.031.7234.197.802.9537.825.822.6044.675.702.0736.32
934.831.6333.757.422.7637.205.572.4543.995.411.9435.86
944.611.5333.197.062.6036.835.332.3243.535.171.8435.59
954.431.4632.966.712.4436.365.112.2143.254.911.7435.44
964.241.3832.556.382.2935.894.902.0942.654.661.6334.98
974.071.3031.946.072.1535.424.691.9842.224.431.5434.76
983.911.2431.715.752.0134.964.491.8741.654.221.4534.36
993.741.1731.285.491.9234.974.311.7841.304.021.3834.33
1003.591.1030.645.211.7834.174.121.6840.783.821.2933.77
), ArticleFig(id=1321170640820884187, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=CN, label=表2, caption=

中国不同居住方式老年人LE、HLE和HLE/LE

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄/岁独居老年人与家人同住老年人
男性女性男性女性
LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%
6514.777.0447.6623.9312.1450.7316.619.8059.0019.098.9646.94
6614.316.7347.0323.1211.6250.2616.129.4258.4418.398.5446.44
6713.786.3946.3722.4211.1849.8715.569.0057.8417.788.1645.89
6813.346.1245.8821.6610.7049.4015.088.6557.3617.097.7845.52
6912.845.8345.4020.9010.2248.9014.538.2356.6416.477.4245.05
7012.385.5544.8320.119.7448.4314.027.8756.1315.807.1044.94
7111.935.2744.1719.419.2847.8113.487.4955.5615.176.7344.36
7211.505.0143.5718.748.9047.4913.057.1754.9414.596.4043.87
7311.054.7643.0818.058.4947.0412.556.8154.2613.956.0743.51
7410.624.5242.5617.358.1046.6912.166.5553.8713.405.7843.13
7510.254.3142.0516.727.6845.9311.666.2353.4312.825.4842.75
769.834.0841.5116.077.3145.4911.255.9352.7112.245.1742.24
779.453.8841.0615.426.9645.1410.815.6352.0811.754.9241.87
789.083.6840.5314.786.5744.4510.395.3751.6811.224.6441.35
798.743.4939.9314.186.2544.0810.015.1351.2510.754.4341.21
808.393.3239.5713.585.8943.379.644.8750.5210.254.1640.59
818.033.1338.9813.005.6043.089.264.6350.009.743.9340.35
827.722.9838.6012.495.3242.598.854.3849.499.363.7239.74
837.392.8138.0211.925.0142.038.504.1749.068.913.5339.62
847.112.6837.6911.394.7441.628.153.9548.478.483.3139.03
856.792.5237.1110.904.4841.107.833.7547.898.093.1338.69
866.532.3936.6010.374.2340.797.493.5647.537.702.9538.31
876.242.2636.229.933.9940.187.203.3947.087.312.7838.03
885.972.1335.689.453.7639.796.893.2146.596.972.6237.59
895.742.0335.379.043.5539.276.633.0546.006.642.4837.35
905.481.9134.858.613.3238.566.332.8845.506.302.3236.83
915.251.8234.678.203.1438.296.082.7445.076.012.2036.61
925.031.7234.197.802.9537.825.822.6044.675.702.0736.32
934.831.6333.757.422.7637.205.572.4543.995.411.9435.86
944.611.5333.197.062.6036.835.332.3243.535.171.8435.59
954.431.4632.966.712.4436.365.112.2143.254.911.7435.44
964.241.3832.556.382.2935.894.902.0942.654.661.6334.98
974.071.3031.946.072.1535.424.691.9842.224.431.5434.76
983.911.2431.715.752.0134.964.491.8741.654.221.4534.36
993.741.1731.285.491.9234.974.311.7841.304.021.3834.33
1003.591.1030.645.211.7834.174.121.6840.783.821.2933.77
), ArticleFig(id=1321170640896381660, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=EN, label=Tab.3, caption=

LE, HLE, and HLE/LE ratios of urban and rural elderly living in different ways in China

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄/岁独居老年人与家人同住老年人
城市农村城市农村
LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%LE/ 年HLE/年(HLE/LE)/%LE/ 年HLE/年(HLE/LE)/%
6520.5510.0248.7620.1310.9754.5018.529.0648.9217.289.6755.96
6619.999.7848.9219.4310.4453.7318.038.8849.2516.659.1855.14
6719.459.5248.9518.719.8852.8117.558.6849.4615.948.6554.27
6818.889.2949.2117.989.3752.1117.038.4849.7915.368.2153.45
6918.269.0649.6217.368.9451.5016.538.2649.9714.737.7552.61
7017.748.8249.7216.648.4250.6016.008.0550.3114.107.2851.63
7117.238.6049.9116.007.9749.8115.527.8550.5813.556.8850.77
7216.678.3750.2115.387.5449.0215.057.6550.8312.996.4849.88
7316.178.1350.2814.807.1348.1814.597.4551.0612.406.0849.03
7415.657.9350.6714.206.7547.5414.117.2651.4511.895.7448.28
7515.117.6750.7613.646.3746.7013.667.0751.7611.365.3747.27
7614.567.4250.9613.096.0145.9113.196.8952.2410.885.0546.42
7714.077.2151.2412.525.6745.2912.766.6852.3510.414.7245.34
7813.586.9951.4712.025.3444.4312.366.5352.839.954.4444.62
7913.076.7451.5711.515.0043.4411.846.2953.139.524.1543.59
8012.576.5151.7911.044.7242.7511.416.0853.299.083.8942.84
8112.056.2651.9510.574.4241.8211.005.9153.738.693.6241.66
8211.676.0952.1910.114.1541.0510.605.7354.068.293.3840.77
8311.215.8752.369.673.8840.1210.205.5754.617.943.1840.05
8410.755.6552.569.283.6639.449.855.3954.727.602.9538.82
8510.315.4352.678.863.4238.609.445.2155.197.252.7638.07
869.895.2352.888.463.2137.949.085.0455.516.902.5737.25
879.485.0353.068.113.0137.118.714.8555.686.592.3936.27
889.064.8253.207.732.8036.228.374.6956.036.312.2235.18
898.704.6453.337.392.6235.458.034.5456.546.032.0834.49
908.304.4353.377.082.4534.607.714.3956.945.731.9233.51
917.974.2853.706.772.2933.837.384.2157.055.501.8032.73
927.604.0853.686.462.1332.977.104.0757.325.241.6631.68
937.263.9053.726.211.9932.056.823.9357.625.001.5531.00
946.953.7553.965.891.8431.246.543.7857.804.801.4329.79
956.643.5853.925.641.7230.506.303.6658.104.601.3328.91
966.353.4354.025.411.6129.766.033.5258.374.401.2428.18
976.073.2854.045.181.5028.965.783.3858.484.221.1527.25
985.773.1153.904.961.3928.025.563.2758.814.051.0626.17
995.542.9953.974.741.3027.435.363.1658.963.880.9925.52
1005.292.8553.884.531.2026.495.133.0459.263.710.9224.80
), ArticleFig(id=1321170640984462045, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170623800398474, language=CN, label=表3, caption=

中国不同居住方式城市和农村老年人LE、HLE和HLE/LE

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄/岁独居老年人与家人同住老年人
城市农村城市农村
LE/年HLE/年(HLE/LE)/%LE/年HLE/年(HLE/LE)/%LE/ 年HLE/年(HLE/LE)/%LE/ 年HLE/年(HLE/LE)/%
6520.5510.0248.7620.1310.9754.5018.529.0648.9217.289.6755.96
6619.999.7848.9219.4310.4453.7318.038.8849.2516.659.1855.14
6719.459.5248.9518.719.8852.8117.558.6849.4615.948.6554.27
6818.889.2949.2117.989.3752.1117.038.4849.7915.368.2153.45
6918.269.0649.6217.368.9451.5016.538.2649.9714.737.7552.61
7017.748.8249.7216.648.4250.6016.008.0550.3114.107.2851.63
7117.238.6049.9116.007.9749.8115.527.8550.5813.556.8850.77
7216.678.3750.2115.387.5449.0215.057.6550.8312.996.4849.88
7316.178.1350.2814.807.1348.1814.597.4551.0612.406.0849.03
7415.657.9350.6714.206.7547.5414.117.2651.4511.895.7448.28
7515.117.6750.7613.646.3746.7013.667.0751.7611.365.3747.27
7614.567.4250.9613.096.0145.9113.196.8952.2410.885.0546.42
7714.077.2151.2412.525.6745.2912.766.6852.3510.414.7245.34
7813.586.9951.4712.025.3444.4312.366.5352.839.954.4444.62
7913.076.7451.5711.515.0043.4411.846.2953.139.524.1543.59
8012.576.5151.7911.044.7242.7511.416.0853.299.083.8942.84
8112.056.2651.9510.574.4241.8211.005.9153.738.693.6241.66
8211.676.0952.1910.114.1541.0510.605.7354.068.293.3840.77
8311.215.8752.369.673.8840.1210.205.5754.617.943.1840.05
8410.755.6552.569.283.6639.449.855.3954.727.602.9538.82
8510.315.4352.678.863.4238.609.445.2155.197.252.7638.07
869.895.2352.888.463.2137.949.085.0455.516.902.5737.25
879.485.0353.068.113.0137.118.714.8555.686.592.3936.27
889.064.8253.207.732.8036.228.374.6956.036.312.2235.18
898.704.6453.337.392.6235.458.034.5456.546.032.0834.49
908.304.4353.377.082.4534.607.714.3956.945.731.9233.51
917.974.2853.706.772.2933.837.384.2157.055.501.8032.73
927.604.0853.686.462.1332.977.104.0757.325.241.6631.68
937.263.9053.726.211.9932.056.823.9357.625.001.5531.00
946.953.7553.965.891.8431.246.543.7857.804.801.4329.79
956.643.5853.925.641.7230.506.303.6658.104.601.3328.91
966.353.4354.025.411.6129.766.033.5258.374.401.2428.18
976.073.2854.045.181.5028.965.783.3858.484.221.1527.25
985.773.1153.904.961.3928.025.563.2758.814.051.0626.17
995.542.9953.974.741.3027.435.363.1658.963.880.9925.52
1005.292.8553.884.531.2026.495.133.0459.263.710.9224.80
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中国不同居住方式老年人预期寿命和健康预期寿命差异性分析:基于CLHLS数据库
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赵菲 1 , 谢瑞瑞 2 , 丁莉莉 1 , 吴炳义 1, *, * , 董惠玲 3, *, *
中国公共卫生 | 专题报道——守护老年健康,提升生命质量 2025,41(12): 1423-1428
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中国公共卫生 |专题报道——守护老年健康,提升生命质量 2025 , 41 (12) : 1423 -1428
中国不同居住方式老年人预期寿命和健康预期寿命差异性分析:基于CLHLS数据库
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赵菲1, 谢瑞瑞2, 丁莉莉1, 吴炳义1, *, * , 董惠玲3, *, *
作者信息
  • 1山东第二医科大学管理学院,潍坊 261053
  • 2山东第二医科大学公共卫生学院,潍坊 261053
  • 3山东第二医科大学护理学院,潍坊 261053
通讯作者:
吴炳义,E-mail:
董惠玲,E-mail:
作者简介:

赵菲(2001—),硕士在读,研究方向:社会保障

Differences in life expectancy and healthy life expectancy of the elderly living in different ways in China: an analysis based on CLHLS
Fei ZHAO1, Ruirui XIE2, Lili DING1, Bingyi WU1 , Huiling DONG3
Affiliations
  • 1School of Management, Shandong Second Medical University, Weifang 261053, China
  • 2School of Public Health, Shandong Second Medical University, Weifang 261053, China
  • 3School of Nursing, Shandong Second Medical University, Weifang 261053, China
  • Corresponding Author:
    WU Bingyi, E-mail:
    DONG Huiling, E-mail:
出版时间: 2025-12-10 doi: 10.11847/zgggws1147324
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目的

分析中国不同居住方式老年人的预期寿命(LE)和健康预期寿命(HLE)以及性别和城乡差异,为优化我国老年人居住安排、提升其HLE提供数据支持。

方法

收集2014和2018年中国老年健康影响因素跟踪调查(CLHLS)2期4 503名≥65岁老年人相关数据,采用微观仿真法测算老年人在“独居”和“与家人同住”2种居住状态下的LE、HLE和健康余寿占比(HLE/LE),并比较不同性别和城乡的差异。

结果

中国独居和与家人同住65~100岁老年人的LE分别为20.12~4.72年和17.59~4.13年,HLE分别为10.12~1.78年和9.26~1.70年,HLE/LE分别为50.30%~37.71%和52.64%~41.16%。男性独居和与家人同住65~100岁老年人的LE分别为14.77~3.59年和16.61~4.12年,HLE分别为7.04~1.10年和9.80~1.68年,HLE/LE分别为47.66%~30.64%和59.00%~40.78%;女性独居和与家人同住65~100岁老年人的LE分别为23.93~5.21年和19.09~3.82年,HLE分别为12.14~1.78年和8.96~1.29年,HLE/LE分别为50.73%~34.17%和46.94%~22.77%;各年龄男性独居老年人的LE、HLE、HLE/LE和与家人同住男性老年人的LE均低于女性老年人,与家人同住男性老年人的HLE和HLE/LE均高于女性老年人,独居男性老年人的LE、HLE和HLE/LE均低于与家人同住男性老年人,独居女性老年人的LE、HLE和HLE/LE均高于与家人同住女性老年人。城市独居和与家人同住65~100岁老年人的LE分别为20.55~5.29年和18.52~5.13年,HLE分别为10.02~2.85年和9.06~3.04年,HLE/LE分别为48.76%~53.88%和48.92%~59.26%;农村独居和与家人同住65~100岁老年人的LE分别为20.13~4.53年和17.28~3.71年,HLE分别为10.97~1.20年和9.67~0.92年,HLE/LE分别为54.50%~26.49%和55.96%~24.80%;各年龄城市老年人的LE均高于农村老年人,除城市65~68岁独居老年人及65和66岁与家人同住老年人的HLE低于农村老年人外,其他各年龄老年人的HLE均高于农村老年人;随着年龄增长,农村老年人的HLE/LE逐渐下降,而城市老年人的HLE/LE逐渐上升。

结论

中国独居老年人的LE和HLE普遍高于与家人同住老年人,但HLE/LE较低,其中女性和城市独居老年人在LE和HLE上更具优势,而与家人同住男性老年人的LE和HLE均高于独居男性老年人。

健康预期寿命  /  差异性分析  /  居住方式  /  老年人  /  预期寿命  /  中国
Objective

To analyze the life expectancy (LE) and healthy life expectancy (HLE) of the elderly living in different ways in China, as well as gender and urban-rural differences, thus providing data support for optimizing the living arrangements and improving the HLE of the elderly in China.

Methods

The data of 4 503 elderly people aged 65 years old and above in 2014 and 2018 of Chinese Longitudinal Healthy Longevity Survey (CLHLS) were collected. The LE, HLE, and HLE/LE ratio of the elderly living alone and living with their families were measured by the micro-simulation method and compared between different genders as well as between urban and rural areas.

Results

The LE of 65–100 elderly living alone and living with their families in China were 20.12–4.72 years and 17.59–4.13 years, respectively. The HLE were 10.12–1.78 years and 9.26–1.70 years, respectively. The HLE/LE were 50.30%–37.71% and 52.24% –41.16 %, respectively. The LE of men living alone and living with their families for 65 years and 100 years old were 14.77–3.59 years, 16.61–4.12 years, respectively. The HLE were 7.04–1.10 years, 9.80–1.68 years, respectively. The HLE/LE were 47.66%–30.64%, 59.00%–40.78%, respectively. The LE of women living alone and living with their families for 65–100 years old were 23.93–5.21 years and 19.09–3.82 years, respectively. The HLE were 12.14–1.78 years and 8.96–1.29 years, respectively. The HLE/LE were 50.73%–34.17% and 46.96%–22.77%, respectively. The LE, HLE, HLE/LE of male elderly living alone and male elderly living with family were lower than those of female elderly. The HLE and HLE/LE of male elderly living with family were higher than those of female elderly. The LE, HLE and HLE/LE of male elderly living alone were lower than those of male elderly living with family. The LE, HLE and HLE/LE of female elderly living alone were higher than those of female elderly living with family. The LE of the elderly living alone in the city and living with their families for 65–100 years were 20.55–5.29 years and 18.52–5.13 years, respectively. The HLE were 10.02–2.85 years and 9.06–3.04 years, respectively. The HLE/LE were 48.76%–53.88% and 48.92–59.26%, respectively. The LE of the elderly living alone in rural areas and living with their families for 65–100 years were 20.13–4.53 years and 17.28–3.71 years, respectively. The HLE were 10.97–1.20 years and 9.67–0.92 years, respectively. The HLE/LE were 54.50%–26.49% and 55.96%–24.80%, respectively. The LE of the urban elderly at all ages was higher than that of the rural elderly. Except that the HLE of the urban elderly aged 65-68 and the elderly aged 65 and 66 living with their families was lower than that of the rural elderly, the HLE of the elderly at other ages was higher than that of the rural elderly. With the increase of age, the HLE/LE of the rural elderly gradually decreased, while the HLE/LE of the urban elderly gradually increased.

Conclusions

The LE and HLE of the elderly living alone are generally higher than those living with their families, while the HLE/LE ratio demonstrates an opposite trend. Female elderly and the elderly living alone in urban areas have higher LE and HLE, while the male elderly living with their families have higher LE and HLE than the male elderly living alone.

healthy life expectancy  /  difference analysis  /  way of living  /  the elderly  /  life expectancy  /  China
赵菲, 谢瑞瑞, 丁莉莉, 吴炳义, 董惠玲. 中国不同居住方式老年人预期寿命和健康预期寿命差异性分析:基于CLHLS数据库. 中国公共卫生, 2025 , 41 (12) : 1423 -1428 . DOI: 10.11847/zgggws1147324
Fei ZHAO, Ruirui XIE, Lili DING, Bingyi WU, Huiling DONG. Differences in life expectancy and healthy life expectancy of the elderly living in different ways in China: an analysis based on CLHLS[J]. Chinese Journal of Public Health, 2025 , 41 (12) : 1423 -1428 . DOI: 10.11847/zgggws1147324
中国人口老龄化进程的持续深化对养老服务和社会保障体系提出了严峻挑战。2023年统计数据显示,中国≥65岁老年人口占比已突破14%,其中≥60岁独居老年人比例达11%~14%[1]。健康预期寿命(healthy life expectancy, HLE)作为国民生命质量的综合性测度指标[2],不仅衡量生存年限,更关注健康状态下的有效生活年限,为老龄化研究提供了新的分析视角。有研究表明,老年人居住方式与其健康状态存在显著关联,居住模式主要分为独居、与家人同住和机构养老等形式[3],不同模式对健康的影响呈现出差异化特征。有研究发现,独居老年人可能具有更好的健康状态[4]且认知功能衰退较缓[5]。然而,也有研究表明,独居可能增加健康风险,如独居老年人慢性病共病患病率更高[6]。还有研究则支持与家人同住的积极效应[7–9]。马琦峰等[10]研究表明,与子女同住老年人的自评生活质量更优,这种研究结论的分歧凸显了深入探讨居住方式与健康关系的必要性。为分析中国不同居住方式老年人的预期寿命(life expectancy, LE)和HLE以及性别和城乡差异,为优化我国老年人居住安排、提升其HLE提供数据支持,本研究收集2014和2018年中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey, CLHLS)2期4 503名≥65岁老年人相关数据,采用微观仿真法测算老年人在“独居”和“与家人同住”2种居住状态下的LE、HLE和健康余寿占比(HLE/LE),并比较不同性别和城乡的差异。结果报告如下。
资料来源于CLHLS数据库。该调查由北京大学健康老龄与发展研究中心组织,覆盖中国23个省(自治区、直辖市)。数据面向学术界开放共享,数据收集过程严格遵循科研伦理规范,并通过北京大学医学部伦理审查委员会审查批准,批号为:IRB00001052-13074。本研究提取其中2014和2018年2期追踪队列数据,经过样本清洗,剔除关键变量含有缺失值的样本后,最终纳入4 503名≥65岁老年人的相关数据进行分析。本研究保留的变量包括性别、年龄、城乡、居住方式和自评健康状况。CLHLS数据库将老年人居住方式划分为独居、与家人同住和在养老机构居住3类,但由于在养老机构居住的老年人占比较低,本研究仅保留“独居”和“与家人同住”2种居住方式的老年人进行分析。在数据处理时,将数据整理为长面板数据,保留每一期老年人的居住方式,并在微观仿真法模拟过程中模拟居住方式的动态转变,以保证数据研究的可靠性。CLHLS数据库中将自评健康状况分为“健康”“比较健康”“一般”“比较不健康”和“不健康”5种。本研究将“健康”和“比较健康”合并为“健康”“一般”“比较不健康”和“不健康”合并为“不健康”。
本研究基于多项式logit模型计算出不同居住方式下各健康状态的转移概率,将测算出的转移概率作为参数,使用微观仿真法测算老年人HLE。本研究将健康状态分为2个非吸收状态(健康、不健康)和一个吸收状态(死亡),分别赋值为1、2、3,刻画出健康状态转移路径。
健康状态转移概率矩阵用于刻画个体健康状态在相邻时间点间的动态演变规律,是预测个体健康未来轨迹的核心工具。下列矩阵中T中的元素Pij表示个体在时点t处于健康状态i(i=1,2)时,在时点t+1转移至状态j(j=1,2,3)的概率,且每行概率满足$ \displaystyle\sum_{i=1}^{3} P_{i j}=1 $。
矩阵形式为:T=$ \left[\begin{array}{lll}P_{11} & P_{12} & P_{13} \\P_{21} & P_{22} & P_{23}\end{array}\right] $
本研究基于一阶马尔可夫链假设,采用多分类logistic回归模型估计转移概率。模型假定为:
$\begin{split} mlogit\left(\mathrm{state}_{t+1}\right)=&\beta_0+\beta_1\mathrm{state}_t+\beta_2\mathrm{age}_t+\beta_3\mathrm{sex}+ \\&\beta_4\mathrm{residence}+\varepsilon\end{split} $
其中,因变量为2018年健康状态(statet+1),自变量为2014年健康状态(statet)、年龄(age)、性别(sex)、城乡(residence)。β代表回归系数,ε代表误差项。
将上述计算出的健康转移概率,进一步使用微观仿真法测算老年人的HLE。微观仿真法的核心机制是借助蒙特卡洛模拟技术,通过随机数生成算法从健康状态的概率分布中选取个体的状态转换路径,进而精确模拟个体在模型中的状态转换过程[11]。在模型运行过程中,微观仿真法通常采用离散事件仿真或连续时间马尔可夫链算法,按周期性更新个体的健康状态,通过生存随机模拟判定个体的存活周期,动态计算疾病发生、康复或失能等关键健康事件的发生时点。此外,利用事件历史记录器追踪个体的健康生存年数和病损生存年数。通过大规模重复模拟,结合Bootstrap方法计算HLE及其置信区间。具体操作步骤为:基于初始状态矩阵,创建一个规模为 10万人,年龄为 65岁,性别、城乡、健康状态等均符合总体特征的初始仿真样本;基于1年期转移概率矩阵,模拟微观个体从 65岁到死亡(或 100 岁)期间每年的健康状态,从而生成仿真队列的完整健康轨迹数据。其后,计算个体在65~100岁的总人年数和处于非失能状态的人年数,并进一步在人口层面获得 65岁时分性别、分城乡的LE和HLE。同时,利用30次重复的 bootstrap方法获得各估计值的置信区间。
2014年纳入分析的4 503名≥65岁老年人中,男性2 196人(48.77%),女性2 307人(51.23%);年龄65~69岁173人(3.84%),70~74岁687人(15.26%),75~79岁1 011人(22.45%),80~85岁582人(12.92%),≥85岁2 050人(45.53%);城市1 912人(42.46%),农村2 591人(57.54%);独居3 590人(79.72%),与家人同住913人(20.28%);自评不健康2 472人(54.90%),健康2 031人(45.10%)。
随着年龄的增长,无论是独居还是与家人居住,中国老年人的LE、HLE和HLE/LE均呈下降态势;其中,独居老年人较与家人同住老年人的LE和HLE高,但HLE/LE则较低。
随着年龄的增长,男性、女性独居和与家人同住老年人LE、HLE和HLE/LE均呈下降趋势。各年龄男性独居老年人的LE、HLE、HLE/LE和与家人同住男性老年人的LE均低于女性老年人;与家人同住男性老年人的HLE和HLE/LE均高于女性老年人;独居男性老年人的LE、HLE和HLE/LE均低于与家人同住男性老年人;独居女性老年人的LE、HLE和HLE/LE均高于与家人同住女性老年人。如图2和图3所示,老年人的LE和HLE均随年龄的增长呈下降趋势,不同性别老年人在独居和与家人同住的LE和HLE上存在差异,独居男性老年人的LE和HLE均低于与家人同住男性老年人,独居女性老年人的LE和HLE均高于与家人同住女性老年人,且这种差距随年龄增长逐渐缩小,男性老年人缩小幅度高于女性老年人。
随着年龄的增长,城市、农村独居和与家人同住老年人LE、HLE和HLE/LE均呈下降趋势。各年龄城市老年人的LE均高于农村老年人,除城市65~68岁独居老年人及65和66岁与家人同住老年人的HLE低于农村老年人外,其他各年龄老年人的HLE均高于农村老年人,独居城市和农村老年人的LE和HLE均高于与家人同住城市和农村老年人。随着年龄增长,农村老年人的HLE/LE逐渐下降,而城市老年人的HLE/LE逐渐上升。如图4和图5所示,老年人的LE和HLE均随年龄的增长呈下降趋势;城市、农村老年人在独居和与家人同住的LE和HLE上存在差异,城市和农村独居老年人的LE、HLE均高于与家人同住老年人;且这种差距均随年龄增长逐渐缩小,城市老年人缩小幅度高于农村老年人。
本研究结果显示,在相同年龄老年人中,独居者的LE、HLE和HLE/LE均高于与家人同住者,与曾翔等[12 – 13]运用多状态生命表计算不同居住方式对中国老年人HLE影响的结果一致。提示中国独居老年人较与家人同住的老年人表现出更高的HLE。这可能与独居老年人在生活习惯和作息规律方面拥有更大的自主权,可根据自身需求灵活调整,有利于维持良好的健康状态有关。相比之下,与家人同住的老年人可能面临着代际关系紧张的问题,这会对他们的健康产生负面影响[14]。而独居老年人则能有效避免家庭矛盾,保持更好的心理健康状态,进而体现在更高的HLE上。
本研究结果显示,不同居住方式下老年人的HLE存在性别差异。女性独居老年人的LE和HLE普遍高于男性,上海市奉贤区的研究亦表明,<70岁女性独居老年人在HLE方面超过男性[15]。这可能与女性在健康管理和生活方式上的优势有关,她们通常更注重健康饮食、定期体检和慢性病管理。此外,传统家庭结构中女性承担较多的家务和照料责任,长期的家庭负担可能影响其健康,而独居生活则可能减少这些压力,从而改善其健康状况。与此相反的是,与家人同住男性老年人的HLE则表现更优,这可能与家庭角色和性别分工有关。在家庭环境中,男性通常能获得更多生活照料和情感支持,子女的督促和照顾有助于他们养成良好生活的习惯,从而改善其健康状况。总体而言,独居女性老年人的HLE更高,可能源于更积极的健康管理和社会参与,而与家人同住男性老年人的HLE更高则与家庭支持密切相关。
本研究结果还显示,不同居住方式对老年人的HLE亦存在城乡差异。在城市和农村的老年人中,不同居住方式对LE和HLE的影响表现出显著差异。各年龄城市老年人的LE均高于农村老年人,除城市65~68岁独居老年人及65和66岁与家人同住老年人的HLE低于农村老年人外,其他各年龄老年人的HLE均高于农村老年人,这可能与城市完善的社会支持体系有关。在城市居住的老年人通常经济条件较好,社会参与度高,且能够便捷获取医疗服务和健康管理[16],这些因素都将有助于延长LE和HLE。此外,在城市和农村老年人中,独居者的LE和HLE亦均高于与家人同住者,提示独居依然是老年人HLE的促进因素。
随着中国人口老龄化的加速,老年人健康问题备受关注。本研究采用微观仿真法测算了独居和与家人同住2种居住方式老年人的LE、HLE和HLE/LE。研究发现,中国独居老年人的LE和HLE普遍高于与家人同住老年人,但HLE/LE较低。其中女性和城市独居老年人在LE和HLE上更具优势,而与家人同住男性老年人的LE和HLE均高于独居男性老年人。提示在未来政策的制定中需关注独居老年人的健康支持,同时优化家庭养老环境,以提升老年人整体健康水平。相较于传统的多状态生命表法,微观仿真法能够以更为精细的粒度模拟个体健康状态的转换过程,精准预测特定人群的健康与生存轨迹,并充分考虑个体特征的异质性以及疾病史的累积效应;同时支持时间变量的动态调整,使其能够灵活适应随时间变化的外部因素和个体特征。此外,微观模拟模型是基于个体层面的数据架构,可完整跟踪个体的疾病史,并在分析中纳入大量个体特征变量,从而在理论上实现更高的精准度,尤其适用于人群异质性较高的研究场景[17]。相比之下,多状态生命表法主要依赖群体层面的宏观信息构建模型,在纳入复杂个体因素方面存在相对局限性。因此,微观仿真模型为HLE的研究提供了一种更为精确且灵活的分析工具,能够有效弥补传统方法的不足。但本研究仍存在一定的研究局限性,如,本研究中独居老年人的HLE可能部分归因于健康状况较好的老年人具备较强的自我照顾能力且享受独立生活的自由与自主性。因此,更倾向于选择独居,而这种自我选择机制的影响需要进一步的实证研究来验证。此外,本研究仅关注了独居和与家人同住2种居住方式,未涵盖其他居住方式(如养老机构居住)。因此,今后的研究中可进一步拓展样本范围和居住方式的分类进行深入分析。

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doi: 10.11847/zgggws1147324
  • 接收时间:2025-03-06
  • 首发时间:2026-10-25
  • 出版时间:2025-12-10
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  • 收稿日期:2025-03-06
  • 修回日期:2025-05-24
  • 录用日期:2025-07-25
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    1山东第二医科大学管理学院,潍坊 261053
    2山东第二医科大学公共卫生学院,潍坊 261053
    3山东第二医科大学护理学院,潍坊 261053

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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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