[目的] 对作为国家重大战略发展区域之一的长江经济带的生态系统健康状况进行诊断，为推进区域生态与经济社会的协调发展提供科学依据。[方法] ①以长江经济带城市群为研究对象，从活力、组织结构、恢复力、生态系统服务和人群健康5个维度出发，构建长江经济带生态系统健康诊断指标体系；②根据生态系统健康标准将其划分为病态、不健康、亚健康、健康和很健康5个等级，并基于熵权法确定诊断指标权重；③构建正态云模型，对长江经济带2000，2009，2018年生态系统健康状况进行综合诊断。[结果] 从2000年至2018年，长江经济带无论从整体还是省市层面上的生态系统健康等级均有所提升，2018年底整个研究区的生态系统健康状况普遍已趋于亚健康水准。[结论] 人口密度、人均可支配收入、人均耕地面积和人均地区GDP是影响长江经济带生态系统健康的主要因素。因此，关注人口发展规划，提高人均可支配收入，严守耕地红线，注重城市科学健康扩张，耦合经济发展和生态保护的关系尤为重要。
[Objective] The health of the ecosystem of the Yangtze River economic belt, one of the major strategic development regions of China, was diagnosed in order to provide a scientific basis for promoting the coordinated development of the regional ecology and economic society.[Methods] ① The urban agglomerations of the Yangtze River economic belt were taken as the research area. Starting from the five dimensions of vitality, organizational structure, resilience, ecosystem services, and population health, an ecosystem health diagnostic index system for the Yangtze River economic belt was constructed. ② According to ecosystem health standards, the area was divided into the following five levels:sickness, unhealthy, sub-healthy, healthy, and very healthy. Diagnostic index weights were then determined based on the entropy weight method. ③ A normal cloud model was constructed to comprehensively diagnose the health of the ecosystem of the Yangtze River economic belt in 2000, 2009, and 2018.[Results] From 2000 to 2018, the ecosystem health level along the Yangtze River economic belt had been improved at both the overall level and at the provincial and municipal levels. At the end of 2018, the ecosystem health status of the entire study area had generally tended to the sub-health level.[Conclusion] Population density, per capita disposable income, per capita arable land area, and per capita regional GDP were the main factors affecting the ecosystem health of the Yangtze River economic belt. Therefore, it is particularly important to give attention to population development planning, increase per capita disposable income, strictly observe the red line of arable land, give attention to the scientific and healthy expansion of cities, and couple the relationship between economic development and ecological protection.