目的 探讨社区2型糖尿病(diabetes mellitus,type 2;T2DM)患者睡眠质量与抑郁症状之间的关系.方法 采用多阶段整群随机抽样方法,抽取徐州市37个村/社区,每个村/社区符合标准的患者均纳入此次研究,应用自行设计的一般情况调查表和匹兹堡睡眠质量指数量表、焦虑自评量表和抑郁自评量表对T2DM患者进行面对面评估,并对患者的糖化血红蛋白进行检测.按照睡眠质量好、差及有、无抑郁症状进行分组,组间数据比较采用t检验或x2检验.采用Spearman相关分析两因素之间的关系,以单因素分析中有意义的变量为自变量进行非条件Logistic回归.结果 共纳入研究对象1 000例,有效调查979例T2DM患者.其中,睡眠质量差者比例为34.42％(337/979),抑郁症状占T2DM患者的40.96％(401/979).睡眠质量好者中,抑郁症状的发生率为31.93％(205/642),而睡眠质量差者的抑郁症状的发生率为58.16％(196/337),两者差异有统计学意义(x2=62.87,P＜0.01).匹兹堡睡眠质量指数得分与抑郁自评量表得分密切相关(r=0.388,P＜0.01);调整年龄、文化程度、家庭月收入、病程、并发症、合并其他疾病等混杂因素后,睡眠质量与T2DM患者抑郁的发生相关(OR=1.56,95％CI 1.13～2.15);4个睡眠维度(主观睡眠质量差、睡眠时间短、睡眠障碍和日间功能障碍)与抑郁存在关联(OR直分别为1.65、2.06、1.52、1.87).结论 T2DM患者主观睡眠质量差、睡眠时间短、睡眠障碍和日间功能障碍与抑郁相关联.“,”Objective To assess the association between sleep quality and depression symptom in patients with type 2 diabetes mellitus (T2DM) in communities.Methods Thirty-seven communities in Xuzhou city were taken out by cluster sampling in the survey.The patients who met with the criteria were included in the study.Each subject completed a version of a self-designed questionnaire,and the Pittsburgh Sleep Quality Index (PSQI),Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS).Glycosylated hemoglobin A1c (HbA1c) were measured.The patients were grouped according to having sleep problem or depression symptomor not.An independent-samples t-test or chi-square test was used to analyse differences between two groups.Spearman correlation was used for analysis of relationship.Multiple logistic regression analysis was used to examine the relationships between sleep quality and depression.Results A total of 1 000 eligible T2DM patients were invited into the study.Overall,979 T2DM patients were involved in the study.34.42％ (337/979) of T2DM patients were poor sleepers according to their PSQI scores.The rate of depression symptom was 40.96％(401/979).The rate of depression symptom was 31.93％(205/642) in T2DM patients with good sleep quality,and 58.16％ (196/337) in T2DM patients with poor sleep quality,and difference was significant (x2=62.87,P＜0.01).The score of PSQI had significantly higher SDS (r=0.388,P＜0.01).After adjustment for confounders(such as age,the level of education,household income per month,a longer duration of diabetes,diabetes complications etc),poor sleep quality was positively associated with depression symptom in T2DM patients (OR=1.56,95％ CI 1.13-2.15).Conclusions It shows that poor sleep be correlated with the risk of depression symptom in T2DM patient.