目的 分析华东地区FQ镇65岁及以上老年人慢性病共病的流行现状、核心共病模式及其影响因素，以揭示该地区老年人群的健康负担特征及共病趋势，为制定符合乡镇基层特点的慢性病共病精准防控策略与管理方案提供实证依据。方法 采用横断面研究设计，收集2024年FQ镇12028名65岁及以上老年人健康体检数据。分析高血压、糖尿病、脑卒中等8种常见慢性病的患病率与共病率。运用疾病计数法描述共病组合，并采用Apriori关联规则算法挖掘疾病间的强关联模式。基于健康生态学模型框架，通过单因素及多因素Logistic回归分析，从先天特质、个体行为、人际网络与生活条件等多层面探讨慢性病共病的影响因素。结果 华东地区FQ镇老年人纳入慢性病管理比例为64.9%，总体慢性病共病患病率为20.2%。高血压患病率最高（59.7%），是该地区共病网络的绝对核心。关联规则分析显示，二元共病模式呈现高度集中的特征，“糖尿病→高血压”（置信度95.89%）、“脑卒中→高血压”（置信度93.93%）和“冠心病→高血压”（置信度90.00%）为置信度最高的强关联规则，显著高于全国平均水平。共病模式存在年龄与性别异质性：75-79岁年龄组共病驱动核心从代谢性疾病转向“心肌梗塞→高血压”和“慢性支气管炎→高血压”；老年女性中“慢性支气管炎→高血压”关联显现。多因素分析表明，高龄、超重/肥胖是共病的独立危险因素，其中肥胖的风险极高（OR=21.7）。参加医疗保险是共病的保护因素。结论 华东农村FQ镇老年人慢性病共病负担虽低于全国报告水平，但以高血压为核心的代谢-心脑血管疾病共病模式极为突出且关联强度惊人。高龄、肥胖是主要危险因素，而医疗保障可及性具有保护作用。研究提示，基层慢性病防控需突破单病种诊疗思维，实施对糖尿病、脑卒中患者的同步血压管理，并依据年龄、性别差异制定分层、精准的健康管理与教育策略。本研究为优化乡镇基层慢性病共病综合防治实践提供了直接、具体的科学参考。

Objective This study was conducted to systematically analyze the epidemic status, core co-morbidities patterns and influencing factors of chronic diseases among elderly people aged 65 and above in FQ town in East China, so as to reveal the health burden characteristics and co-morbidities trends of the elderly population in this area, and provide empirical evidence for formulating precise prevention and control strategies and management programs for chronic diseases in accordance with the characteristics of grass-roots villages and towns. Methods A cross-sectional study design was adopted to collect health examination data of 12,028 elderly people aged 65 and above in FQ town in 2024. Prevalence and comorbidity of 8 common chronic diseases such as hypertension, diabetes mellitus and stroke were analyzed. Disease counting method was used to describe comorbidity combinations, and Apriori association rule algorithm was used to mine strong association patterns among diseases. Based on the health ecology model framework, single factor and multiple factor Logistic regression analysis were used to explore the influencing factors of chronic disease comorbidity from multiple aspects such as congenital traits, individual behavior, interpersonal network and living conditions. Results In FQ town, 64.9% of the elderly were included in chronic disease management, and the overall prevalence of chronic diseases was 20.2%. Hypertension had the highest prevalence Association rule analysis showed that the binary comorbidity pattern presented a highly concentrated feature,"diabetes→ hypertension"(Confidence 95.89%), Stroke→Hypertension (93.93% confidence) and "coronary heart disease→hypertension" There was age and gender heterogeneity in the co-morbid pattern: the co-morbid driving core shifted from metabolic diseases to "myocardial infarction→hypertension" and "chronic bronchitis→hypertension" in the age group of 75-79; the association of "chronic bronchitis→hypertension" appeared in the elderly women. Multivariate analysis showed that old age and overweight/obesity were independent risk factors for comorbidity, and obesity was the highest risk factor (OR=21.7). Conclusion Although the burden of chronic diseases in FQ town was lower than that reported in China, the metabolic and cardiovascular diseases co-morbidities pattern with hypertension as the core was very prominent and the correlation intensity was amazing. The study suggests that prevention and control of chronic diseases at the grass-roots level should break through the single-disease diagnosis and treatment thinking, implement synchronous blood pressure management for patients with diabetes and stroke, and formulate stratified and accurate health management and education strategies according to age and gender differences.