1990―2019年中国脑卒中发病趋势及其年龄-时期-队列分析

熊文婧; 张敏; 徐杰茹; 张译匀; 姚承志; 赵湘铃; 让蔚清

doi:10.16462/j.cnki.zhjbkz.2023.04.019

1990―2019年中国脑卒中发病趋势及其年龄-时期-队列分析

doi: 10.16462/j.cnki.zhjbkz.2023.04.019

熊文婧^{1, 2},
张敏¹,
徐杰茹¹,
张译匀¹,
姚承志¹,
赵湘铃¹,
让蔚清^1, ,

1.
421001 衡阳，南华大学公共卫生学院预防医学系
2.
421000 衡阳，南华大学附属第一医院中医科

基金项目:

2019年度湖南省芙蓉教学名师专项基金 201RFS001

2020年衡阳市社会科学基金项目资助 2020E004

详细信息

通讯作者:
让蔚清，E-mail：nhurwq@126.com

中图分类号: R181.2;R743.3
计量
- 文章访问数: 1123
- HTML全文浏览量: 341
- PDF下载量: 194
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-17
- 修回日期: 2023-01-05
- 网络出版日期: 2023-04-28
- 刊出日期: 2023-04-10

Incidence trend and age-period-cohort analysis of stroke in China from 1990 to 2019

1.
Department of Preventive Medicine, School of Public Health, University of South, Hengyang 421001, China
2.
Traditional Chinese Medicine Department of the First Affiliated Hospital, University of South, Hengyang 421000, China

Funds:

2019 Hunan Furong Teaching Master Special Fund 201RFS001

Hengyang Social Science Foundation in 2020 2020E004

More Information

Corresponding author: RANG Weiqing, E-mail: nhurwq@126.com

摘要

摘要: 目的分析1990―2019年中国人群脑卒中发病率的变化趋势，并对其主要亚型进行年龄-时期-队列分析。方法从全球疾病负担数据库中提取中国1990―2019年全年龄段脑卒中及其亚型的发病数据，描述其粗发病率和标化发病率的变化趋势，应用年龄-时期-队列(age-period-cohort, APC)模型分析脑卒中主要亚型发病率的年龄、时期和队列效应。结果 1990―2019年中国人群脑卒中标化发病率总体呈下降趋势，但缺血性脑卒中和出血性脑卒中的年龄标化发病率的长期变化趋势并不一致，且两者的年龄标化发病率明显高于蛛网膜下腔出血；出血性脑卒中发病效应系数随年龄的增大逐渐上升，0~ < 5岁年龄组最低(效应值-3.10)，85~ < 90岁最高(效应值1.86)，后者发病风险是前者的142.45倍。时期效应随着年份的增加呈先升后降的态势，队列效应则随着时间的推移呈下降趋势，值得注意的是近年来有小幅度回升；中国缺血性脑卒中发病效应系数随年龄的增大呈先下降后快速上升的变化趋势，20~ < 25岁年龄组效应最低(效应值-2.00)，80~ < 85岁年龄组效应值最高(效应值1.86)，80~ < 85岁年龄组的发病风险是20~ < 25岁的47.45倍。时期效应随着年份的增加而增加，队列效应随时间的推移呈下降趋势。结论 1990―2019年中国人群脑卒中标化发病率总体呈下降趋势，其主要亚型缺血性脑卒中呈上升趋势，年龄越大发生脑卒中的可能性越大，仍需要加强对脑卒中(尤其是缺血性脑卒中)的防控工作。
- 脑卒中 /
- 亚型 /
- 发病率 /
- 变化趋势 /
- 年龄-时期-队列模型
Abstract: Objective The study aims to analyze the changing trend of the incidence rate of stroke and its subtypes in Chinese population from 1990 to 2019, and to investigate the main subtypes by age-period-cohort (APC). Methods The data which including stroke incidence rate and its subtypes at all ages in China from 1990 to 2019 were extracted from the global burden of disease database. The changing trend of the crude and standardized incidence rates was briefly described. The APC model was further applied to analyze the age, period, and cohort effect of the incidence rate of the main stroke subtypes. Results From 1990 to 2019, the overall standardized incidence rate of stroke in Chinese population showed a downward trend. However, the long-term change trend of age-standardized incidence rate of ischemic stroke and hemorrhagic stroke was inconsistent. And the age-standardized incidence rate of ischemic stroke and hemorrhagic stroke was significantly higher than that of subarachnoid hemorrhage. The incidence effect coefficient of hemorrhagic stroke gradually increased with the increase of age, with the lowest in the 0- < 5 age group (effect value -3.10) and the highest in the 85- < 90 age group (effect value 1.86). The risk of the latter was 142.45 times than that of the former. The period effect increases first and then decreases with the these years. While the cohort effect decreases with the passage of time. It is worth noting that there has been a small recovery in recent years. The incidence effect coefficient of ischemic stroke in China showed a trend of first decreasing and then rapidly increasing with age. The effect coefficient of the 20- < 25 age group was the lowest (effect value -2.00), and the 80- < 85 age group had the highest effect value (effect value 1.86). The incidence risk of the 80- < 85 age group was 47.45 times than that of the 20- < 25 age group. The period effect increases with years, and the cohort effect showed a downward trend over time. Conclusions Although the overall standardized incidence rate of stroke in Chinese population from 1990 to 2019 showed a downward trend, its major subtypes of ischemic stroke showed an upward trend. The older people live get, the greater possibility of stroke they will have. It still needs to strengthen the prevention and control of stroke, especially ischemic stroke.
- Stroke /
- Subtype /
- Incidence rate /
- Changing trend /
- APC model

HTML全文

图 1 1990―2019年中国人群脑卒中粗发病率和标化发病率变化趋势

Figure 1. Trends of crude and standardized incidence rate of stroke in Chinese population from 1990 to 2019

下载: 全尺寸图片幻灯片

图 2 1990―2019年中国人群脑卒中及其亚型标化发病率变化趋势

Figure 2. Trends of standardized incidence rate of stroke and its subtypes in Chinese population from 1990 to 2019

下载: 全尺寸图片幻灯片

图 3 1990―2019年中国出血性脑卒中发病风险的年龄、时期和队列效应相对危险度

Figure 3. Age, period and cohort effect relative risk of hemorrhagic stroke in China from 1990 to 2019

下载: 全尺寸图片幻灯片

图 4 1990―2019年中国缺血性脑卒中发病风险的年龄、时期和队列效应相对危险度

Figure 4. Age, period and cohort effect relative risk of ischemic stroke in China from 1990 to 2019

下载: 全尺寸图片幻灯片

表 1 1990―2019年中国出血性脑卒中发病率年龄-时期-队列模型分析

Table 1. Age-period-cohort model analysis of incidence rate of hemorrhagic stroke in China from 1990 to 2019

分组	效应系数	s_x	Z值	P值	95% CI		分组	效应系数	s_x	Z值	P值	95% CI
分组	效应系数	s_x	Z值	P值	下限	上限	分组	效应系数	s_x	Z值	P值	下限	上限
年龄(岁)							队列(年)
0~ < 5	-3.10	0.39	-7.96	＜0.001	-3.86	-2.33	1890―1894	2.21	0.10	22.27	＜0.001	2.01	2.40
5~ < 10	-2.50	0.28	-9.00	＜0.001	-3.05	-1.96	1895―1899	1.94	0.08	22.97	＜0.001	1.77	2.10
10~ < 15	-2.15	0.24	-9.13	＜0.001	-2.62	-1.69	1900―1904	1.67	0.07	23.46	＜0.001	1.53	1.81
15~ < 20	-1.98	0.22	-9.12	＜0.001	-2.41	-1.56	1905―1909	1.39	0.06	23.45	＜0.001	1.27	1.50
20~ < 25	-1.67	0.19	-8.77	＜0.001	-2.04	-1.29	1910―1914	1.10	0.05	22.43	＜0.001	1.00	1.20
25~ < 30	-1.33	0.17	-7.99	＜0.001	-1.66	-1.00	1915―1919	0.83	0.04	19.82	＜0.001	0.75	0.91
30~ < 35	-0.81	0.14	-5.84	＜0.001	-1.09	-0.54	1920―1924	0.62	0.04	15.68	＜0.001	0.54	0.70
35~ < 40	-0.38	0.12	-3.14	＜0.001	-0.61	-0.14	1925―1929	0.46	0.04	10.90	＜0.001	0.38	0.55
40~ < 45	0.13	0.10	1.21	0.230	-0.08	0.32	1930―1934	0.33	0.05	6.60	＜0.001	0.23	0.43
45~ < 50	0.51	0.09	5.96	＜0.001	0.34	0.68	1935―1939	0.17	0.06	2.84	＜0.001	0.05	0.29
50~ < 55	0.70	0.07	9.66	＜0.001	0.55	0.84	1940―1944	-0.03	0.07	-0.47	0.640	-0.18	0.11
55~ < 60	0.79	0.06	13.12	＜0.001	0.67	0.90	1945―1949	-0.21	0.09	-2.44	0.020	-0.38	-0.04
60~ < 65	0.87	0.05	17.77	＜0.001	0.77	0.97	1950―1954	-0.37	0.10	-3.69	＜0.001	-0.56	-0.17
65~ < 70	0.94	0.04	23.14	＜0.001	0.86	1.02	1955―1959	-0.52	0.11	-4.57	＜0.001	-0.74	-0.30
70~ < 75	1.26	0.04	36.06	＜0.001	1.19	1.33	1960―1964	-0.65	0.13	-5.06	＜0.001	-0.91	-0.40
75~ < 80	1.56	0.04	43.38	＜0.001	1.49	1.63	1965―1969	-0.75	0.15	-5.19	＜0.001	-1.04	-0.47
80~ < 85	1.76	0.04	40.86	＜0.001	1.68	1.84	1970―1974	-0.83	0.16	-5.09	＜0.001	-1.15	-0.51
85~ < 90	1.86	0.05	34.69	＜0.001	1.75	1.96	1975―1979	-0.90	0.18	-4.93	＜0.001	-1.26	-0.54
90~ < 95	1.82	0.07	27.65	＜0.001	1.69	1.95	1980―1984	-0.97	0.20	-4.76	＜0.001	-1.37	-0.57
≥95	1.74	0.08	21.96	＜0.001	1.58	1.89	1985―1989	-1.02	0.23	-4.43	＜0.001	-1.47	-0.57
时期(年)							1990―1994	-1.05	0.27	-3.94	＜0.001	-1.57	-0.53
1990―1994	-0.31	0.04	-8.27	＜0.001	-0.39	-0.24	1995―1999	-1.03	0.32	-3.26	＜0.001	-1.65	-0.41
1995―1999	＜0.001	0.02	-0.05	0.960	-0.05	0.05	2000―2004	-0.93	0.38	-2.43	0.020	-1.69	-0.18
2000―2004	0.26	0.01	21.33	＜0.001	0.24	0.28	2005―2009	-0.78	0.51	-1.53	0.130	-1.79	0.22
2005―2009	0.25	0.010	18.31	＜0.001	0.22	0.27	2010―2014	-0.65	0.89	-0.73	0.460	-2.40	1.10
2010―2014	-0.04	0.03	-1.58	0.110	-0.09	0.01	截距	4.23	0.05	83.62	＜0.001	4.130	4.33
2015―2019	-0.15	0.04	-3.92	＜0.001	-0.22	-0.08	对数似然比	-450.63
							AIC	8.31
							BIC	-159.45

下载: 导出CSV

表 2 1990―2019年中国缺血性脑卒中发病率年龄-时期-队列模型分析

Table 2. Age-period-cohort model analysis of incidence rate of ischemic stroke in China from 1990 to 2019

分组	效应系数	s_x	Z值	P值	95% CI		分组	效应系数	s_x	Z值	P值	95% CI
分组	效应系数	s_x	Z值	P值	下限	上限	分组	效应系数	s_x	Z值	P值	下限	上限
年龄(岁)							队列(年)
0~ < 5	-0.66	0.13	-4.93	＜0.001	-0.92	-0.40	1890―1894	1.53	0.07	21.58	＜0.001	1.39	1.67
5~ < 10	-1.11	0.13	-8.29	＜0.001	-1.38	-0.85	1895―1899	1.34	0.06	23.04	＜0.001	1.22	1.45
10~ < 15	-1.58	0.15	-10.73	＜0.001	-1.87	-1.29	1900―1904	1.16	0.05	24.57	＜0.001	1.07	1.26
15~ < 20	-1.93	0.16	-12.28	＜0.001	-2.24	-1.62	1905―1909	0.97	0.04	25.55	＜0.001	0.89	1.04
20~ < 25	-2.00	0.15	-13.33	＜0.001	-2.29	-1.71	1910―1914	0.76	0.03	25.90	＜0.001	0.70	0.82
25~ < 30	-1.85	0.13	-13.99	＜0.001	-2.11	-1.59	1915―1919	0.61	0.02	27.56	＜0.001	0.57	0.66
30~ < 35	-1.70	0.12	-14.20	＜0.001	-1.93	-1.46	1920―1924	0.55	0.02	27.59	＜0.001	0.51	0.59
35~ < 40	-1.57	0.11	-14.29	＜0.001	-1.78	-1.35	1925―1929	0.49	0.02	21.90	＜0.001	0.45	0.54
40~ < 45	-1.01	0.09	-11.47	＜0.001	-1.18	-0.84	1930―1934	0.44	0.03	15.18	＜0.001	0.39	0.50
45~ < 50	-0.49	0.07	-6.71	＜0.001	-0.63	-0.34	1935―1939	0.38	0.04	9.94	＜0.001	0.30	0.45
50~ < 55	0.16	0.06	2.69	0.010	0.04	0.27	1940―1944	0.30	0.05	6.40	＜0.001	0.21	0.40
55~ < 60	0.68	0.05	14.42	＜0.001	0.58	0.77	1945―1949	0.26	0.06	4.44	＜0.001	0.14	0.37
60~ < 65	1.12	0.04	30.14	＜0.001	1.05	1.19	1950―1954	0.20	0.07	2.92	＜0.001	0.07	0.34
65~ < 70	1.49	0.03	50.75	＜0.001	1.43	1.54	1955―1959	0.13	0.08	1.58	0.110	-0.03	0.29
70~ < 75	1.70	0.02	69.52	＜0.001	1.65	1.75	1960―1964	0.01	0.09	0.13	0.900	-0.17	0.20
75~ < 80	1.82	0.02	76.26	＜0.001	1.77	1.87	1965―1969	-0.13	0.11	-1.20	0.230	-0.35	0.08
80~ < 85	1.86	0.03	66.94	＜0.001	1.80	1.91	1970―1974	-0.29	0.13	-2.31	0.020	-0.54	-0.04
85~ < 90	1.81	0.04	52.38	＜0.001	1.74	1.88	1975―1979	-0.47	0.14	-3.40	＜0.001	-0.74	-0.20
90~ < 95	1.70	0.04	39.66	＜0.001	1.62	1.79	1980―1984	-0.64	0.14	-4.60	＜0.001	-0.91	-0.37
≥95	1.56	0.05	29.89	＜0.001	1.46	1.67	1985―1989	-0.81	0.14	-5.99	＜0.001	-1.07	-0.54
时期(年)							1990―1994	-1.03	0.15	-6.84	＜0.001	-1.32	-0.73
1990―1994	-0.41	0.03	-14.63	＜0.001	-0.46	-0.35	1995―1999	-1.23	0.17	-7.44	＜0.001	-1.55	-0.90
1995―1999	-0.21	0.02	-11.38	＜0.001	-0.25	-0.17	2000―2004	-1.38	0.18	-7.65	＜0.001	-1.73	-1.03
2000―2004	-0.02	0.01	-1.31	0.190	-0.04	0.01	2005―2009	-1.51	0.21	-7.35	＜0.001	-1.92	-1.11
2005―2009	0.11	0.01	9.61	＜0.001	0.09	0.13	2010―2014	-1.64	0.29	-5.59	＜0.001	-2.21	-1.06
2010―2014	0.21	0.02	11.50	＜0.001	0.18	0.25	截距	4.53	0.03	172.22	＜0.001	4.48	4.58
2015―2019	0.31	0.03	11.59	＜0.001	0.26	0.37	对数似然比	-497.34
							AIC	9.09
							BIC	-117.64

下载: 导出CSV

参考文献(22)

[1]	《中国脑卒中防治报告2020》编写组. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志, 2022, 19(2): 136-144. DOI: 10.3969/j.issn.1672-5921.2022.02.011. Brief report on stroke prevention and treatment in China, 2020. Report on stroke prevention and treatment in China Writing Group[J]. Chin J Cerebrovasc Dis, 2022, 19(2): 136-144. DOI: 10.3969/j.issn.1672-5921.2022.02.011.
[2]	王亚楠, 吴思缈, 刘鸣. 中国脑卒中15年变化趋势和特点[J]. 华西医学, 2021, 36(6): 803-807. DOI: 10.7507/1002-0179.202105046. Wang YA, Wu SM, Liu M. Temporal trends and characteristics of stroke in China in the past 15 years[J]. West China Med J, 2021, 36(6): 803-807. DOI: 10.7507/1002-0179.202105046.
[3]	潘阵江, 鲍晶, 郁翠, 等. 上海市杨浦区40岁及以上常住居民脑卒中流行状况及影响因素分析[J]. 实用预防医学, 2022, 29(2): 230-233. DOI: 10.3969/j.issn.1006-3110.2022.02.028. Pan ZJ, Bao J, Yu C, et al. Prevalence and influencing factors of stroke among residents aged 40 and over in Yangpu District, Shanghai[J]. Pract Prev Med, 2022, 29(2): 230-233. DOI: 10.3969/j.issn.1006-3110.2022.02.028.
[4]	刘咪, 王晨冉, 梁娟娟, 等. 中国1990-2017年脑卒中及其危险因素疾病负担变化趋势分析[J]. 中国公共卫生, 2021, 37(10): 1501-1507. DOI: 10.11847/zgggws1128349. Liu M, Wang CR, Liang JJ, et al. Change trend in disease burden of stroke and its risk factors in China, 1990-2017[J]. Chin J Public Health, 2021, 37(10): 1501-1507. DOI: 10.11847/zgggws1128349.
[5]	曹新西, 徐晨婕, 侯亚冰, 等. 1990―2025年我国高发慢性病的流行趋势及预测[J]. 中国慢性病预防与控制, 2020, 28(1): 14-19. DOI: 10.16386/j.cjpccd.issn.1004-6194.2020.01.004. Cao XX, Xu CJ, Hou YB, et al. The epidemic trend and prediction of chronic diseases with high incidence in China from 1990 to 2025[J]. Chin J Prev Control Chron Dis, 2020, 28(1): 14-19. DOI: 10.16386/j.cjpccd.issn.1004-6194.2020.01.004.
[6]	GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Neurol, 2021, 20(10): 795-820. DOI: 10.1016/S1474-4422(21)00252-0.
[7]	Ma QF, Li R, Wang LJ, et al. Temporal trend and attributable risk factors of stroke burden in China, 1990-2019: an analysis for the Global Burden of Disease Study 2019[J]. Lancet Public Health, 2021, 6(12): e897-e906. DOI: 10.1016/S2468-2667(21)00228-0.
[8]	Liang J, Li X, Kang C, et al. Maternal mortality ratios in 2852 Chinese counties, 1996-2015, and achievement of Millennium Development Goal 5 in China: a subnational analysis of the Global Burden of Disease Study 2016[J]. Lancet, 2019, 393(10168): 241-252. DOI: 10.1016/S0140-6736(18)31712-4.
[9]	Zhou MG, Wang HD, Zeng XY, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet, 2019, 394(10204): 1145-1158. DOI: 10.1016/S0140-6736(19)30427-1.
[10]	屈彦, 王天一, 杨津, 等. GBD数据库的数据提取方法与流程[J]. 中国循证心血管医学杂志, 2019, 11(9): 1043-1046. DOI: 10.3969/j.issn.1674-4055.2019.09.04. Qu Y, Wang TY, Yang J, et al. GBD database application and data extraction methods and processes[J]. Chin J Evid Based Cardiovasc Med, 2019, 11(9): 1043-1046. DOI: 10.3969/j.issn.1674-4055.2019.09.04.
[11]	Siegel R, Miller K, Jemal A. Cancer statistics, 2020[J]. CA Cancer J Clin, 2020, 70(1): 7-30. DOI: 10.3322/caac.21590.
[12]	苏晶晶, 彭非. 年龄-时期-队列模型参数估计方法最新研究进展[J]. 统计与决策, 2014, 5(23): 21-26. DOI: 10.13546/j.cnki.tjyjc.2014.23.005. Su JJ, Peng F. The latest research progress of parameter estimation methods in age age cohort model[J]. Statistics and Decision, 2014, 5(23): 21-26. DOI: 10.13546/j.cnki.tjyjc.2014.23.005.
[13]	华淑名. "年龄-时期-队列"效应模型的应用与发展[J]. 信息系统工程. 2019, (9): 73-74. DOI: 10.3969/j.issn.1001-2362.2019.09.046. Hua SM. Application and Development of "Age-period-cohort" Effect Model. Information Systems Engineering. 2019, (9): 73-74. DOI: 10.3969/j.issn.1001-2362.2019.09.046.
[14]	Gregory AR, George AM, Catherine OJ, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019[J]. J Am Coll Cardiol, 2020, 76(25): 2982-3021. DOI: 10.1016/j.jacc.2020.11.010.
[15]	孙环, 夏昱, 陈艳梅, 等. 脑卒中发病的危险因素分析[J]. 护理实践与研究, 2022, 19(15): 2243-2247. DOI: 10.3969/j.issn.1672-9676.2022.15.008. Sun H, Xia Y, Chen YM, et al. Risk factors anslysis of stroke[J]. Nur Prac Res, 2022, 19(15): 2243-2247. DOI: 10.3969/j.issn.1672-9676.2022.15.008.
[16]	王蒙. 中国人口老龄化问题研究[J]. 中国经贸导刊, 2021, (8): 158-160. https://www.cnki.com.cn/Article/CJFDTOTAL-JMDL202103058.htm Wang M. Research on the aging of China's population[J]. China Economic Trade Herald, 2021, (8): 158-160. https://www.cnki.com.cn/Article/CJFDTOTAL-JMDL202103058.htm
[17]	李娜, 王浩, 阮钰涵, 等. 1990-2019年浙江省脑卒中疾病负担和危险因素变化趋势研究[J]. 疾病监测, 2022, 37(7): 901-906. DOI: 10.3784/jbjc.202205130222. Li N, Wang H, Ruan YH, et al. Disease burden of stroke and related risk factors in Zhejiang, 1990-2019[J]. Dis Surveill, 2022, 37(7): 901-906. DOI: 10.3784/jbjc.202205130222.
[18]	周璐, 吕素景, 王晓鸣, 等. 郑州地区城市和农村中老年人群脑卒中危险因素比较研究[J]. 华南预防医学, 2022, 48(6): 715-717. DOI: 10.12183/j.scjpm.2022.0715. Zhou L, Lu SJ, Wang XM, et al. Comparative study on risk factors of stroke between urban and rural middle-aged and elderly people in zhengzhou[J]. South China J Prev Med, 2022, 48(6): 715-717. DOI: 10.12183/j.scjpm.2022.0715.
[19]	李欣, 栾德春, 任时, 等. 2010-2012年年辽宁省18岁以上居民饮酒行为调查研究[J]. 中国预防医学杂志, 2020, 21(1): 16-21. DOI: 10.16506/j.1009-6639.2020.01.004. Li X, Luan DC, Ren S, et al. Suevey on the drinking behavior of residents aged 18 and above in liaoning in 2010-2012[J]. Chin Prev Med, 2020, 21(1): 16-21. DOI: 10.16506/j.1009-6639.2020.01.004.
[20]	张莎, 钟佳利, 黄鑫, 等. 多参数集成序列在急性缺血性脑卒中诊断中的应用价值[J]. 磁共振成像, 2022, 13(7): 107-111. DOI: 10.12015/issn.1674-8034.2022.07.019. Zhang S, Zhong JL, Huang X, et al. The application value of MTP synthetic sequence in the diagnosis of acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2022, 13(7): 107-111. DOI: 10.12015/issn.1674-8034.2022.07.019.
[21]	李丹丹. 20世纪50、60年代《人民日报》对爱国卫生运动的宣传动员研究(1952-1966)[D]. 绵阳: 西南科技大学. 2022. Li DD. Research on the propaganda and mobilization of the patriotic health campaign by the people's daily in the 1950s and 1960s (1952-1966)[D]. Mianyang: Southwest University of Science and Technology, 2022.
[22]	高琼珠, 夏结婷, 李亚洁, 等. 不同时机营养干预对急性脑卒中预后的临床影响[J]. 中国康复医学杂志, 2020, 35(2): 213-215. DOI: 10.3969/j.issn.1001-1242.2020.02.019. Gao QZ, Xia JT, Li YJ, et al. Clinical effect of nutritional intervention at different time on prognosis of acute stroke[J]. Chin J Rehabil Med, 2020, 35(2): 213-215. DOI: 10.3969/j.issn.1001-1242.2020.02.019.