
Chinese General Practice ›› 2026, Vol. 29 ›› Issue (17): 2334-2339.DOI: 10.12114/j.issn.1007-9572.2024.0597
Special Issue: 内分泌代谢性疾病最新文章合辑; 社区卫生服务最新研究合辑
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Received:2025-10-10
Revised:2025-12-30
Published:2026-06-15
Online:2026-05-21
Contact:
HE Yilin
通讯作者:
何义林
作者简介:作者贡献:
李孟林进行调查设计、数据整理与分析以及论文的撰写,并对文章负责;丁芳、钱瑜、浦栋、杜乾乾、管天航负责研究的实施,进行数据的收集与整理;何义林提出研究的构思、设计,进行论文的修订。
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2024.0597
| 外显变量 | 赋值 |
|---|---|
| HbA1c | <7%=0,≥7%=1 |
| 年龄 | <65岁=0,≥65岁=1 |
| BMI | <24 kg/m2=0,≥24 kg/m2=1 |
| 健康素养 | <8分=0,≥8分=1 |
| 病程 | <10年=0,≥10年=1 |
| 直系亲属是否患病 | 否=0,是=1 |
| 是否有合并症/并发症 | 否=0,是=1 |
| 是否出现过低血糖 | 否=0,是=1 |
Table 1 Variable assignment for latent classes model
| 外显变量 | 赋值 |
|---|---|
| HbA1c | <7%=0,≥7%=1 |
| 年龄 | <65岁=0,≥65岁=1 |
| BMI | <24 kg/m2=0,≥24 kg/m2=1 |
| 健康素养 | <8分=0,≥8分=1 |
| 病程 | <10年=0,≥10年=1 |
| 直系亲属是否患病 | 否=0,是=1 |
| 是否有合并症/并发症 | 否=0,是=1 |
| 是否出现过低血糖 | 否=0,是=1 |
| 模型类别数 | AIC | BIC | aBIC | Pearson χ2 | G2 | P值 | Entropy | |
|---|---|---|---|---|---|---|---|---|
| LMRT | BLRT | |||||||
| 1 | 4 004.633 | 4 036.897 | 4 011.511 | 391.550 | 342.541 | — | — | — |
| 2 | 3 979.032 | 4 047.594 | 3 993.649 | 347.657 | 299.335 | 0.003 | <0.001 | 0.811 |
| 3 | 3 966.737 | 4 071.597 | 3 989.092 | 351.334 | 270.166 | <0.001 | 0.013 | 0.979 |
| 4 | 3 963.677 | 4 104.835 | 3 993.771 | 366.364 | 249.107 | 0.446 | 0.200 | 0.816 |
Table 2 Model fitting indicators for latent classes
| 模型类别数 | AIC | BIC | aBIC | Pearson χ2 | G2 | P值 | Entropy | |
|---|---|---|---|---|---|---|---|---|
| LMRT | BLRT | |||||||
| 1 | 4 004.633 | 4 036.897 | 4 011.511 | 391.550 | 342.541 | — | — | — |
| 2 | 3 979.032 | 4 047.594 | 3 993.649 | 347.657 | 299.335 | 0.003 | <0.001 | 0.811 |
| 3 | 3 966.737 | 4 071.597 | 3 989.092 | 351.334 | 270.166 | <0.001 | 0.013 | 0.979 |
| 4 | 3 963.677 | 4 104.835 | 3 993.771 | 366.364 | 249.107 | 0.446 | 0.200 | 0.816 |
| 组别 | 例数 | 高血压 | 冠心病 | 高脂血症 | 脑卒中 | 糖尿病肾病 | 糖尿病足 | 视网膜病变 | 神经病变 | 其他 |
|---|---|---|---|---|---|---|---|---|---|---|
| 高龄-低健康素养组 | 181 | 128(70.72)a | 26(14.36) | 47(25.97) | 32(17.68)a | 10(5.52) | 11(6.08) | 39(21.55) | 44(24.31)a | 4(2.21) |
| 中龄-中等健康素养组 | 158 | 120(75.95)a | 24(15.19) | 41(25.95) | 27(17.09)a | 4(2.53) | 9(5.70) | 35(22.15) | 39(24.68)a | 4(2.53) |
| 低龄-高健康素养组 | 78 | 38(48.72) | 10(12.82) | 18(23.08) | 2(2.56) | 3(3.85) | 5(6.41) | 8(10.26) | 6(7.69) | 4(5.13) |
| χ2值 | 18.648 | 0.238 | 0.278 | 11.206 | 1.946 | 0.051 | 5.395 | 10.657 | 1.770 | |
| P值 | <0.001 | 0.888 | 0.870 | 0.004 | 0.378 | 0.975 | 0.067 | 0.005 | 0.413 |
Table 3 Distribution of complications in patients with diabetes mellitus in subgroups with different glycaemic control profiles
| 组别 | 例数 | 高血压 | 冠心病 | 高脂血症 | 脑卒中 | 糖尿病肾病 | 糖尿病足 | 视网膜病变 | 神经病变 | 其他 |
|---|---|---|---|---|---|---|---|---|---|---|
| 高龄-低健康素养组 | 181 | 128(70.72)a | 26(14.36) | 47(25.97) | 32(17.68)a | 10(5.52) | 11(6.08) | 39(21.55) | 44(24.31)a | 4(2.21) |
| 中龄-中等健康素养组 | 158 | 120(75.95)a | 24(15.19) | 41(25.95) | 27(17.09)a | 4(2.53) | 9(5.70) | 35(22.15) | 39(24.68)a | 4(2.53) |
| 低龄-高健康素养组 | 78 | 38(48.72) | 10(12.82) | 18(23.08) | 2(2.56) | 3(3.85) | 5(6.41) | 8(10.26) | 6(7.69) | 4(5.13) |
| χ2值 | 18.648 | 0.238 | 0.278 | 11.206 | 1.946 | 0.051 | 5.395 | 10.657 | 1.770 | |
| P值 | <0.001 | 0.888 | 0.870 | 0.004 | 0.378 | 0.975 | 0.067 | 0.005 | 0.413 |
| 组别 | 例数 | 性别 | 受教育程度 | 婚姻状况 | 职业 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| 男 | 女 | 小学及以下 | 初中及以上 | 已婚 | 未婚/离异/丧偶 | 自由职业/其他 | 非自由职业 | |||
| 高龄-低健康素养组 | 181 | 72(39.78) | 109(60.22) | 154(85.08) | 27(14.92) | 141(77.90) | 40(22.10) | 152(83.98) | 29(16.02) | |
| 中龄-中等健康素养组 | 158 | 51(32.28) | 107(67.72) | 130(82.28) | 28(17.72) | 118(74.68) | 40(25.32) | 131(82.91) | 27(17.09) | |
| 低龄-高健康素养组 | 78 | 28(35.90) | 50(64.10) | 44(56.41) | 34(43.59) | 72(92.31) | 6(7.69) | 49(62.82) | 29(37.18) | |
| χ2值 | 2.059 | 28.681 | 10.334 | 16.737 | ||||||
| P值 | 0.357 | <0.001 | 0.006 | <0.001 | ||||||
| 组别 | 家庭年收入a | 年内家医随访频次a | 接受家医服务项目数a | 控制血糖措施数 | 是否按时监测血糖a | |||||
| ≤4万元 | >4万元 | ≤4次 | >4次 | ≤3项 | >3项 | ≤3项 | >3项 | 基本/大多数时候 | 偶尔/基本不 | |
| 高龄-低健康素养组 | 121(72.02) | 47(27.98) | 47(26.11) | 133(73.89) | 101(55.80) | 80(44.20) | 137(75.69) | 44(24.31) | 147(82.58) | 31(17.42) |
| 中龄-中等健康素养组 | 107(73.79) | 38(26.21) | 35(22.29) | 122(77.71) | 99(62.66) | 59(37.34) | 97(61.39) | 61(38.61) | 131(83.44) | 26(16.56) |
| 低龄-高健康素养组 | 44(57.89) | 32(42.11) | 19(25.68) | 55(74.32) | 50(64.10) | 28(35.90) | 35(44.87) | 43(55.13) | 67(85.90) | 11(14.10) |
| χ2值 | 6.614 | 0.719 | 2.341 | 23.692 | 0.435 | |||||
| P值 | 0.037 | 0.698 | 0.310 | <0.001 | 0.805 | |||||
Table 4 Single factor analysis of potential categories of diabetic patients with different glycaemic control profiles
| 组别 | 例数 | 性别 | 受教育程度 | 婚姻状况 | 职业 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| 男 | 女 | 小学及以下 | 初中及以上 | 已婚 | 未婚/离异/丧偶 | 自由职业/其他 | 非自由职业 | |||
| 高龄-低健康素养组 | 181 | 72(39.78) | 109(60.22) | 154(85.08) | 27(14.92) | 141(77.90) | 40(22.10) | 152(83.98) | 29(16.02) | |
| 中龄-中等健康素养组 | 158 | 51(32.28) | 107(67.72) | 130(82.28) | 28(17.72) | 118(74.68) | 40(25.32) | 131(82.91) | 27(17.09) | |
| 低龄-高健康素养组 | 78 | 28(35.90) | 50(64.10) | 44(56.41) | 34(43.59) | 72(92.31) | 6(7.69) | 49(62.82) | 29(37.18) | |
| χ2值 | 2.059 | 28.681 | 10.334 | 16.737 | ||||||
| P值 | 0.357 | <0.001 | 0.006 | <0.001 | ||||||
| 组别 | 家庭年收入a | 年内家医随访频次a | 接受家医服务项目数a | 控制血糖措施数 | 是否按时监测血糖a | |||||
| ≤4万元 | >4万元 | ≤4次 | >4次 | ≤3项 | >3项 | ≤3项 | >3项 | 基本/大多数时候 | 偶尔/基本不 | |
| 高龄-低健康素养组 | 121(72.02) | 47(27.98) | 47(26.11) | 133(73.89) | 101(55.80) | 80(44.20) | 137(75.69) | 44(24.31) | 147(82.58) | 31(17.42) |
| 中龄-中等健康素养组 | 107(73.79) | 38(26.21) | 35(22.29) | 122(77.71) | 99(62.66) | 59(37.34) | 97(61.39) | 61(38.61) | 131(83.44) | 26(16.56) |
| 低龄-高健康素养组 | 44(57.89) | 32(42.11) | 19(25.68) | 55(74.32) | 50(64.10) | 28(35.90) | 35(44.87) | 43(55.13) | 67(85.90) | 11(14.10) |
| χ2值 | 6.614 | 0.719 | 2.341 | 23.692 | 0.435 | |||||
| P值 | 0.037 | 0.698 | 0.310 | <0.001 | 0.805 | |||||
| 变量 | B | SE | P值 | OR(95%CI) |
|---|---|---|---|---|
| 类别1(高龄-低健康素养组) | ||||
| 受教育程度(以小学及以下为参照) | ||||
| 初中及以上 | -1.362 | 0.352 | <0.001 | 0.256(0.129~0.510) |
| 婚姻状况(以已婚为参照) | ||||
| 未婚/离异/丧偶 | 0.928 | 0.515 | 0.071 | 2.530(0.923~6.940) |
| 职业(以自由职业/其他为参照) | ||||
| 非自由职业 | -0.584 | 0.355 | 0.100 | 0558(0.278~1.119) |
| 家庭年收入(以≤4万元为参照) | ||||
| >4万元 | -0.404 | 0.316 | 0.201 | 0.668(0.359~1.241) |
| 控制血糖措施数(以≤3项为参照) | ||||
| >3项 | -1.303 | 0.310 | <0.001 | 0.272(0.148~0.499) |
| 类别2(中龄-中等健康素养组) | ||||
| 受教育程度(以小学及以下为参照) | ||||
| 初中及以上 | -1.035 | 0.343 | 0.003 | 0.355(0.181~0.696) |
| 婚姻状况(以已婚为参照) | ||||
| 未婚/离异/丧偶 | 1.195 | 0.513 | 0.020 | 3.303(1.208~9.035) |
| 职业(以自由职业/其他为参照) | ||||
| 非自由职业 | -0.607 | 0.355 | 0.087 | 0.545(0.272~1.093) |
| 家庭年收入(以≤4万元为参照) | ||||
| >4万元 | -0.536 | 0.318 | 0.092 | 0.585(0.313~1.092) |
| 控制血糖措施数(以≤3项为参照) | ||||
| >3项 | -0.612 | 0.305 | 0.045 | 0.542(0.298~0.986) |
Table 5 Multiple Logistic regression analysis of factors influencing categories of glycemic control in diabetic patients
| 变量 | B | SE | P值 | OR(95%CI) |
|---|---|---|---|---|
| 类别1(高龄-低健康素养组) | ||||
| 受教育程度(以小学及以下为参照) | ||||
| 初中及以上 | -1.362 | 0.352 | <0.001 | 0.256(0.129~0.510) |
| 婚姻状况(以已婚为参照) | ||||
| 未婚/离异/丧偶 | 0.928 | 0.515 | 0.071 | 2.530(0.923~6.940) |
| 职业(以自由职业/其他为参照) | ||||
| 非自由职业 | -0.584 | 0.355 | 0.100 | 0558(0.278~1.119) |
| 家庭年收入(以≤4万元为参照) | ||||
| >4万元 | -0.404 | 0.316 | 0.201 | 0.668(0.359~1.241) |
| 控制血糖措施数(以≤3项为参照) | ||||
| >3项 | -1.303 | 0.310 | <0.001 | 0.272(0.148~0.499) |
| 类别2(中龄-中等健康素养组) | ||||
| 受教育程度(以小学及以下为参照) | ||||
| 初中及以上 | -1.035 | 0.343 | 0.003 | 0.355(0.181~0.696) |
| 婚姻状况(以已婚为参照) | ||||
| 未婚/离异/丧偶 | 1.195 | 0.513 | 0.020 | 3.303(1.208~9.035) |
| 职业(以自由职业/其他为参照) | ||||
| 非自由职业 | -0.607 | 0.355 | 0.087 | 0.545(0.272~1.093) |
| 家庭年收入(以≤4万元为参照) | ||||
| >4万元 | -0.536 | 0.318 | 0.092 | 0.585(0.313~1.092) |
| 控制血糖措施数(以≤3项为参照) | ||||
| >3项 | -0.612 | 0.305 | 0.045 | 0.542(0.298~0.986) |
| [1] |
|
| [2] |
|
| [3] |
中华医学会糖尿病学分会, 国家基层糖尿病防治管理办公室. 国家基层糖尿病防治管理指南(2022)[J].中华内科杂志, 2022, 61(7): 32. DOI: 10.3760/cma.j.cn112138-20220120-000063.
|
| [4] |
尤莉莉, 赵金红, 陈新月, 等. 国家基本公共卫生服务项目实施十年的进展与成效[J]. 中国全科医学, 2022, 25(26): 3209-3220. DOI: 10.12114/j.issn.1007-9572.2022.0407.
|
| [5] |
|
| [6] |
|
| [7] |
|
| [8] |
|
| [9] |
|
| [10] |
温忠麟, 谢晋艳, 王惠惠. 潜在类别模型的原理、步骤及程序[J]. 华东师范大学学报(教育科学版), 2023, 41(1): 1-15. DOI: 10.16382/j.cnki.1000-5560.2023.01.001.
|
| [11] |
中华医学会糖尿病学分会慢性并发症调查组. 1991—2000年全国住院糖尿病患者慢性并发症及相关大血管病变回顾性分析[J]. 中国医学科学院学报, 2002, 24(5):447-451.
|
| [12] |
李慧, 郭立新. 重视糖尿病患者低血糖的防范及干预[J]. 中华内分泌代谢杂志, 2023, 39(4): 297-301. DOI: 10.3760/cma.j.cn311282-20221229-00716.
|
| [13] |
|
| [14] |
|
| [15] |
|
| [16] |
|
| [17] |
张旋, 高亮亮, 刘效荣, 等. 社区2型糖尿病患者糖化血红蛋白达标现状及与健康素养的关系[J]. 中国基层医药, 2022, 29(8): 1209-1213. DOI: 10.3760/cma.j.cn341190-20210829-01006.
|
| [18] |
刘晓娜, 夏庆华, 方红, 等. 健康素养及运动干预控制糖尿病患者血糖水平的效果评估[J]. 中华流行病学杂志, 2018, 39(3): 357-362. DOI: 10.3760/cma.j.issn.0254-6450.2018.03.021.
|
| [19] |
史红晨, 李晓君, 郑燕蓉, 等. 电子健康素养在2型糖尿病患者疾病控制水平和生活方式之间的中介效应[J]. 中华现代护理杂志, 2024, 30(16): 2150-2154. DOI: 10.3760/cma.j.cn115682-20231023-01640.
|
| [20] |
李红玉, 张金梅, 文喆卿, 等. 社区老年糖尿病患者电子健康素养潜在剖面分析与体力活动水平的关系[J]. 中国实用护理杂志, 2024, 40(7): 540-547. DOI: 10.3760/cma.j.cn211501-20231011-00720.
|
| [21] |
樊宗山, 赵凤琼, 黄海, 等. 健康信念与家庭功能对老年糖尿病视网膜病变患者血糖控制的影响[J]. 中华老年病研究电子杂志, 2022, 9(1): 24-27. DOI: 10.3877/cma.j.issn.2095-8757.2022.01.007.
|
| [22] |
朱兰, 潘志刚, 沈福来. 社区老年2型糖尿病患者自我管理与家庭支持现况的质性研究[J]. 中华全科医师杂志, 2024, 23(2): 126-131. DOI: 10.3760/cma.j.cn114798-20230817-00070.
|
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