目的：总结分析湖北省脑卒中分级诊疗模式的组织架构、运行机制、创新策略及实施成效，为全国脑卒 中防治体系建设提供可复制的参考经验。方法：基于“323”攻坚行动政策框架，通过政策分析、行政数据挖掘 及典型实践总结，依托国家及省级卒中中心建设管理平台，系统分析湖北省卒中中心与基层防治站建设、关键 救治时间指标及分级诊疗实施效果。结果：湖北省构建了“省级脑卒中防治中心-市级中心-医疗机构”三级质 控体系及省、市、县、乡、村五级联动组织架构。截至2024年底，建成卒中中心183家（三级22家、二级161家）、 基层卒中防治站1029家，卒中急救地图覆盖189家单位，实现县域急性卒中救治资源全覆盖。全省入院至静 脉溶栓时间（door-to-needle time，DNT）≤60 min达标率达86.95%，发病至静脉溶栓时间（onset-to-needle time， ONT）缩短40 min，基层累计开展静脉溶栓5307例。2021～2024年，三级医院静脉溶栓例数增长117.3%，动脉 取栓增长255.1%；二级医院静脉溶栓增长211.5%，动脉取栓增长696.8%。通过医防融合机制，累计对35岁以 上居民开展高危筛查约2000万人次，培训脑心健康管理师847人，闭环管理超100万人次；部分地区脑卒中死亡 率低于全国及中部地区平均水平。结论：湖北省通过构建三级质控、五级联动的分级诊疗体系，推进技术下沉与 医防融合，显著提升了急性卒中救治效率与基层防治能力，为我国脑卒中分级诊疗提供了可复制的区域经验。

To summarize and analyze the organizational structure, operational mechanisms, innovative strategies, and implementation effectiveness of the stroke tiered diagnosis and treatment model in Hubei Province, so as to provide replicable reference experience for the construction of the national stroke prevention and control system. Methods: Based on the policy framework of the“323”Offensive Action, this study systematically analyzed the construction of stroke centers and primary prevention and treatment stations, key treatment time indicators, and the implementation effects of tiered diagnosis and treatment in Hubei Province. This was achieved through policy analysis, administrative data mining, and summarization of typical practices, relying on national and provincial stroke center construction and management platforms. Results: Hubei Province has established a three-level quality control system (“Provincial Stroke Prevention and Control Center - Municipal Center - Medical Institution”) and a five-level linkage organizational architecture covering province, city, county, township, and village. As of the end of 2024, 183 stroke centers (22 tertiary and 161 secondary) and 1,029 primary stroke prevention and treatment stations had been established. The stroke emergency map covers 189 units, achieving full coverage of acute stroke treatment resources at the county level. The compliance rate for door-to-needle time (DNT) ≤ 60 min across the province reached 86.95%, and onset-to-needle time (ONT) was shortened by 40 min. Primary institutions have performed a cumulative total of 5,307 intravenous thrombolysis cases. From 2021 to 2024, the number of intravenous thrombolysis cases in tertiary hospitals increased by 117.3% , and arterial thrombectomy cases increased by 255.1%; in secondary hospitals, intravenous thrombolysis increased by 211.5%, and arterial thrombectomy increased by 696.8% . Through the mechanism of integrating medical care and prevention, high-risk screening has been conducted for approximately 20 million residents aged over 35, 847 brain-heart health managers have been trained, and closed-loop management has been implemented for over 1 million person-times. Stroke mortality rates in some regions were lower than the national and central region averages. Conclusion: By establishing a three-level quality control and five-level linkage tiered diagnosis and treatment system, and promoting technology transfer to primary care and the integration of medical care and prevention, Hubei Province has significantly improved acute stroke treatment efficiency and primary prevention and treatment capabilities. This provides replicable regional experience for the implementation of stroke tiered diagnosis and treatment in China.