【摘要】 目的 探索2型糖尿病（T2DM）患者抑郁症状的潜在类别及其影响因素，为制定针对性的干预措施提供科学依据。方法 于2021年10月—2022年3月，根据纳入排除标准，选取深圳市3家社区健康服务中心已建档的360例T2DM患者作为研究对象，通过问卷调查收集患者的一般资料，并采用ZUNG氏抑郁自评量表（SDS）测量患者的抑郁症状。采用Mplus 8.0软件进行潜在类别分析，并对T2DM患者的抑郁症状进行分类。采用SPSS 26.0软件进行χ~2检验以及多因素logistic回归分析。结果 潜在类别分析结果表明，T2DM患者的抑郁症状存在3个潜在类别，分别为无抑郁症状组（135例）、中度抑郁-症状高发组（90例）和中度抑郁-躯体症状和焦虑低发组（135例）。多因素logistic回归分析结果显示，与无抑郁症状组相比，非在婚（OR=7.00,95%CI:2.11～23.22）、有吸烟史（OR=2.55,95%CI:1.27～5.10）、病程≥5年（OR=2.64,95%CI:1.48～4.69）的T2DM患者属于中度抑郁-症状高发组的可能性更高，而未参加医疗保险（OR=0.34,95%CI:0.17～0.69）的T2DM患者属于中度抑郁-症状高发组的可能性更低，均有统计学意义（P<0.01）。与无抑郁症状组相比，非在婚（OR=4.42,95%CI:1.38～14.19）、有吸烟史（OR=2.19,95%CI:1.15～4.17）的T2DM患者属于中度抑郁-躯体症状和焦虑低发组的可能性更高，而未参加医疗保险（OR=0.38,95%CI:0.22～0.68）、有饮酒史（OR=0.33,95%CI:0.15～0.73）的T2DM患者属于中度抑郁-躯体症状和焦虑低发组的可能性更低，均有统计学意义（P<0.05,P<0.01）。结论 T2DM患者抑郁症状具有异质性，应对不同抑郁亚组的糖尿病患者采取针对性的心理干预措施。更多还原

【Abstract】 Objective To explore the latent class and influencing factors of depressive symptoms in patients with type 2 diabetes mellitus(T2DM),and provide the scientific basis for proposing targeted intervention measures. Methods According to the inclusion and exclusion criteria,360 T2DM patients who established health records in 3 community health service centers in Shenzhen were selected as the subjects from October 2021 to March 2022. The investigation was performed by collecting the general information of T2DM patients with questionnaires,and measuring the depressive symptoms with Zung self-rating depression scale(SDS). Mplus 8.0 software was used for latent class analysis,and then the depressive symptoms in T2DM patients were classified. SPSS 26.0 software was used for χ~2test,and multivariate logistic regression. Results The latent class analysis showed that T2DM patients had three latent class of depressive symptoms :no depression group(135 cases),moderate depressionhigh symptoms group(90 cases),and moderate depression-low somatic symptoms and anxiety group(135 cases). The multivariate logistic regression analysis showed that as compared with no depression group,T2DM patients with unmarried(OR=7.00,95%CI:2.11-23.22),smoking history(OR=2.55,95%CI:1.27-5.10) and disease course ≥5 years(OR=2.64,95%CI:1.48-4.69) had the high possibility of moderate depression-high symptoms group;while T2DM patients without medical insurance(OR=0.34,95%CI:0.17-0.69) had much lower possibility of moderate depression-high symptoms group,P <0.01;as compared with no depression group,T2DM patients with unmarried(OR=4.42,95%CI:1.38-14.19) and smoking history(OR=2.19,95%CI:1.15-4.17) had the much higher possibility of moderate depression-low somatic symptoms and anxiety group,while T2DM patients with drinking history(OR=0.33,95%CI:0.15-0.73) and without medical insurance(OR=0.38,95%CI:0.22-0.68) had the much lower possibility of moderate depression-low somatic symptoms and anxiety group, P <0. 05, P <0. 01. Conclusion There are heterogenicity of depressive symptoms in T2DM patients,thus targeted psychological intervention should be taken for different depressive subgroups.更多还原