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Article(id=1324078115965772122, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202507090, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1751990400000, receivedDateStr=2025-07-09, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614423027, onlineDateStr=2026-11-02, pubDate=1770652800000, pubDateStr=2026-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614423027, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614423027, creator=13701087609, updateTime=1793614423027, updator=13701087609, issue=Issue{id=1324078037817504735, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='1770652800000', pubDateStr='2026-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614404396, creator='13701087609', updateTime=1793614474144, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078330420527919, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078330420527920, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=405, endPage=410, ext={EN=ArticleExt(id=1324078116230013275, articleId=1324078115965772122, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Health-related quality of life and its influencing factors among adults aged 18-69 years, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the health-related quality of life (HRQoL) and its determinants among adults aged 18-69 in three Chinese provinces, providing evidence for targeted health management strategies.

Methods

Based on the salt reduction action study conducted from 2022 to 2023 in three provinces of China, a total of 1 440 permanent residents aged 18-69 years were selected as survey participants through multi-stage random sampling. The Five-level EuroQoL five-dimensions (EQ-5D-5L) was used to assess health-related quality of life. Tobit regression and ordinary least squares (OLS) regression were employed to analyze factors influencing the utility scores.

Results

This study included a total of 1 426 participants. The health utility value was 1.00 (-0.20, 1.00), and the Visual Analogue Scale (VAS) score was 88 (80, 94), indicating a generally favorable health status. The Tobit regression analysis revealed that age ≥45 years (β=-0.044, 95% CI: -0.080~-0.009), junior high school education (β=0.045, 95% CI: 0.009-0.081), high school education or above (β=0.095, 95% CI: 0.049-0.141), comorbidities (β=-0.125, 95% CI: -0.187~-0.063), salt intake of 5~<10 g (β=-0.067, 95% CI: -0.114~-0.020), and salt intake ≥10 g (β=-0.085,95% CI: -0.133~-0.038) were significant determinants of health utility values (P<0.05). The OLS regression analysis indicated that age ≥45 years (β=-2.227, 95% CI: -3.601~-0.853), high school education or above (β=2.273, 95% CI: 0.561~3.985),medication use (β=-3.716, 95% CI: -5.833~-1.600), presence of cardiometabolic diseases (β=-1.960, 95% CI: -3.557~-0.363), comorbidities (β=-4.686, 95% CI: -7.514~-1.859), and salt intake of 5~<10g (β=-1.656, 95% CI: -3.290~-0.022)significantly influenced VAS scores (P<0.05).

Conclusion

The overall HRQoL among the study participants was generally favorable. However, HRQoL was significantly reduced in individuals with cardiometabolic multimorbidity. Hence, greater emphasis should be placed on the prevention and management of multimorbidity in health administration. Additionally, more attention is needed for residents who are of advanced age, have lower educational attainment, or consume excessive amounts of salt.

, authors=Huan YU1, Qing LI1, Yu-ze XIN2, Min LIU1, ZHUOMA Dan-shi2, Mao-yi TIAN2, Jian-wei XU1, authorsList=Huan YU, Qing LI, Yu-ze XIN, Min LIU, ZHUOMA Dan-shi, Mao-yi TIAN, Jian-wei XU, authorCompany=null, correspAuthors=Jian-wei XU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078116691386716, articleId=1324078115965772122, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=18～69岁成人健康相关生命质量现状及影响因素研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

了解我国三省18～69岁成人健康相关生命质量现况及影响因素，为后续健康管理提供参考依据。

方法

基于2022—2023年开展的中国三省减盐行动评估项目，通过多阶段随机抽样抽取的1 440名18～69岁常驻居民为调查对象。使用欧洲五维健康量表（five-level EuroQoL five-dimensions, EQ-5D-5L）评估健康相关生命质量。采用Tobit回归、普通最小二乘法（ordinary least squares,OLS）回归分析得分的影响因素。

结果

本研究共纳入研究对象1 426名，健康效用值得分为1.00(-0.20, 1.00)，视觉模拟量表（visual analogue scale，VAS）得分为88(80, 94)，总体较好。Tobit回归分析结果显示，年龄≥45岁（β=-0.044, 95% CI：-0.080～-0.009）、初中（β=0.045, 95% CI：0.009～0.081）、高中及以上（β=0.095, 95% CI：0.049～0.141）、患共病（β=-0.125, 95% CI：-0.187～-0.063）、盐摄入量5～<10 g（β=-0.067, 95% CI：-0.114～-0.020）以及盐摄入量≥10 g（β=-0.085, 95% CI：-0.133～-0.038）对健康效用值产生显著影响（P<0.05）。OLS回归分析结果显示年龄≥45岁（β=-2.227, 95% CI：-3.601～-0.853）、高中及以上（β=2.273, 95% CI：0.561～3.985）、服药（β=-3.716, 95% CI：-5.833～-1.600）、患心血管代谢性疾病（β=-1.960, 95% CI：-3.557～-0.363）、患共病（β=-4.686, 95% CI：-7.514～-1.859）以及盐摄入量5～<10 g（β=-1.656, 95% CI：-3.290～-0.022）对VAS得分有显著影响（P<0.05）。

结论

研究对象健康相关生命质量总体较好，心血管代谢性共病患者的健康相关生命质量显著降低，在健康管理中应重视对共病的防治与管理，还应关注高龄、低学历、盐摄入过量的居民。

, authors=于欢1, 李晴1, 辛雨泽2, 刘敏1, 丹诗卓玛2, 田懋一2, 徐建伟1, authorsList=于欢, 李晴, 辛雨泽, 刘敏, 丹诗卓玛, 田懋一, 徐建伟, authorCompany=null, correspAuthors=徐建伟, authorNote=

于欢（2000—），女，硕士在读，研究方向：慢性病防控研究

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徐建伟，E-mail:
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Frontiers in Pharmacology, 2025, 16: 1565962., articleTitle=Salt-sensitive hypertension: role of endothelial and vascular dysfunction and sex, refAbstract=null)], funds=[Fund(id=1324078121166709139, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, awardId=2024ZD0524600, language=CN, fundingSource=四大慢病重大专项(2024ZD0524600), fundOrder=null, country=null), Fund(id=1324078122882179476, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, awardId=APP1169751, language=CN, fundingSource=澳大利亚国家健康与医学研究理事会以及全球慢性疾病合作联盟资助(APP1169751), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078117844820317, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, xref=1., ext=[AuthorCompanyExt(id=1324078117853208926, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, companyId=1324078117844820317, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Health Promotion and Behavioral Intervention, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China), AuthorCompanyExt(id=1324078117865791839, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, companyId=1324078117844820317, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.中国疾病预防控制中心慢性非传染性疾病预防控制中心健康促进与行为干预室，北京 100050)]), AuthorCompany(id=1324078117941289312, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, xref=2., ext=[AuthorCompanyExt(id=1324078117953872225, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, companyId=1324078117941289312, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.哈尔滨医科大学公共卫生学院流行病学教研室)])], figs=[ArticleFig(id=1324078120457871755, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, language=EN, label=Table 1, caption=

Distribution of demographic characteristics and quality of life scores in the study population

, figureFileSmall=null, figureFileBig=null, tableContent=
特征人数(%)健康效用值［M（P25，P75）］Z/H值P值VAS得分［M（P25，P75）］Z/H值P值
总计1 426(100.00)1.00(-0.20, 1.00)88(80,94)
性别-1.9340.053-0.2220.824
女性704(49.37)1.00(0.46, 1.00)86(80,93)
男性722(50.63)1.00(-0.20, 1.00)88(80, 95)
年龄（岁）-6.363<0.01-7.051<0.01
<45730(51.19)1.00(0.63, 1.00)90(80, 95)
≥45696(48.81)1.00(-0.20, 1.00)82(75, 90)
吸烟史0.4450.657-0.2640.792
否943(66.13)1.00(0.14, 1.00)88(80, 94)
是483(33.87)1.00(-0.20, 1.00)88(80, 94)
服药史-7.390<0.01-8.355<0.01
否1 200(84.15)1.00(0.14, 1.00)90(80, 95)
是226(15.85)1.00(-0.20, 1.00)80(70, 90)
教育程度57.171<0.0135.878<0.01
小学453(31.77)1.00(0.14, 1.00)84(76, 90)
初中592(41.51)1.00(-0.20, 1.00)86(80, 95)
高中及以上381(26.72)1.00(0.88, 1.00)90(80, 95)
患病情况85.289<0.0185.556<0.01
健康899(63.04)1.00(0.14, 1.00)90(80, 95)
单病418(29.31)1.00(0.46,1.00)80(75,90)
共病109(7.65)1.00(-0.20, 1.00)80(70, 90)
肥胖-2.1980.028-3.143<0.01
否1 194(83.73)1.00 (-0.20,1.00)90(80,95)
是232(16.27)1.00(0.63, 1.00)85(75, 90)
盐摄入量(g)22.002<0.0112.518<0.01
<5273(19.14)1.00(0.46, 1.00)90(80, 95)
5~<10626(43.90)1.00(-0.20, 1.00)86(80, 94)
≥10527(36.96)1.00(0.14, 1.00)85(80, 90)
), ArticleFig(id=1324078120554340748, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, language=CN, label=表1, caption=

研究对象人口学特征分布及生命质量评分情况

, figureFileSmall=null, figureFileBig=null, tableContent=
特征人数(%)健康效用值［M（P25，P75）］Z/H值P值VAS得分［M（P25，P75）］Z/H值P值
总计1 426(100.00)1.00(-0.20, 1.00)88(80,94)
性别-1.9340.053-0.2220.824
女性704(49.37)1.00(0.46, 1.00)86(80,93)
男性722(50.63)1.00(-0.20, 1.00)88(80, 95)
年龄（岁）-6.363<0.01-7.051<0.01
<45730(51.19)1.00(0.63, 1.00)90(80, 95)
≥45696(48.81)1.00(-0.20, 1.00)82(75, 90)
吸烟史0.4450.657-0.2640.792
否943(66.13)1.00(0.14, 1.00)88(80, 94)
是483(33.87)1.00(-0.20, 1.00)88(80, 94)
服药史-7.390<0.01-8.355<0.01
否1 200(84.15)1.00(0.14, 1.00)90(80, 95)
是226(15.85)1.00(-0.20, 1.00)80(70, 90)
教育程度57.171<0.0135.878<0.01
小学453(31.77)1.00(0.14, 1.00)84(76, 90)
初中592(41.51)1.00(-0.20, 1.00)86(80, 95)
高中及以上381(26.72)1.00(0.88, 1.00)90(80, 95)
患病情况85.289<0.0185.556<0.01
健康899(63.04)1.00(0.14, 1.00)90(80, 95)
单病418(29.31)1.00(0.46,1.00)80(75,90)
共病109(7.65)1.00(-0.20, 1.00)80(70, 90)
肥胖-2.1980.028-3.143<0.01
否1 194(83.73)1.00 (-0.20,1.00)90(80,95)
是232(16.27)1.00(0.63, 1.00)85(75, 90)
盐摄入量(g)22.002<0.0112.518<0.01
<5273(19.14)1.00(0.46, 1.00)90(80, 95)
5~<10626(43.90)1.00(-0.20, 1.00)86(80, 94)
≥10527(36.96)1.00(0.14, 1.00)85(80, 90)
), ArticleFig(id=1324078120642421133, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, language=EN, label=Table 2, caption=

Difficulties in pain and anxiety across different population subgroups

, figureFileSmall=null, figureFileBig=null, tableContent=
特征疼痛或不舒服有困难者(%)χ2值P值焦虑或抑郁有困难者(%)χ2值P值
性别1.690.198.47<0.01
男性119(16.48)92(12.74)
女性104(14.77)60(8.52)
年龄（岁）49.34<0.012.840.09
<4566(9.04)68(9.32)
≥45157(22.56)84(12.07)
吸烟史0.140.701.840.17
否145(15.38)108(11.45)
是78(16.15)44(9.11)
服药史50.68<0.014.38<0.05
否152(12.67)119(9.92)
是71(31.42)33(14.60)
学历30.62<0.019.17<0.01
小学及初中197(18.85)127(12.15)
高中及以上26(6.82)25(6.56)
患病情况63.09<0.0111.20<0.01
健康88(9.79)77(8.57)
患有CMD135(25.62)75(14.23)
肥胖（kg/m2）3.690.053.700.05
BMI<28177(14.82)119(9.97)
BMI≥2846(19.83)33(14.22)
盐摄入量（g）19.28<0.0110.85<0.01
<519(6.96)14(5.13)
≥5204(17.69)138(11.97)
), ArticleFig(id=1324078120713724302, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, language=CN, label=表2, caption=

不同特征人群在疼痛和焦虑两维度的有困难情况

, figureFileSmall=null, figureFileBig=null, tableContent=
特征疼痛或不舒服有困难者(%)χ2值P值焦虑或抑郁有困难者(%)χ2值P值
性别1.690.198.47<0.01
男性119(16.48)92(12.74)
女性104(14.77)60(8.52)
年龄（岁）49.34<0.012.840.09
<4566(9.04)68(9.32)
≥45157(22.56)84(12.07)
吸烟史0.140.701.840.17
否145(15.38)108(11.45)
是78(16.15)44(9.11)
服药史50.68<0.014.38<0.05
否152(12.67)119(9.92)
是71(31.42)33(14.60)
学历30.62<0.019.17<0.01
小学及初中197(18.85)127(12.15)
高中及以上26(6.82)25(6.56)
患病情况63.09<0.0111.20<0.01
健康88(9.79)77(8.57)
患有CMD135(25.62)75(14.23)
肥胖（kg/m2）3.690.053.700.05
BMI<28177(14.82)119(9.97)
BMI≥2846(19.83)33(14.22)
盐摄入量（g）19.28<0.0110.85<0.01
<519(6.96)14(5.13)
≥5204(17.69)138(11.97)
), ArticleFig(id=1324078120805998991, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078115965772122, language=EN, label=Table 3, caption=

Multivariable analysis of factors influencing pain and anxiety ［OR（95% CI）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征疼痛或不舒服焦虑或沮丧
性别
男性1.001.00
女性1.33(0.92~1.92)1.74(1.14~2.66)*
年龄（岁）
<451.001.00
≥451.88(1.33~2.67)*1.04(0.71~1.53)
吸烟史
否1.001.00
是1.14(0.78~1.67)1.04(0.66~1.64)
服药史
否1.001.00
是1.49(0.99~2.25)0.99(0.59~1.64)
学历
小学及初中1.001.00
高中及以上0.50(0.32~0.78)*0.66(0.42~1.06)
患病情况
健康1.001.00
患有1种及以上CMD1.79(1.23~2.62)*1.57(1.02~2.43)*
肥胖（kg/m2）
BMI<281.001.00
BMI≥281.08(0.73~1.60)1.29(0.84~2.00)
盐摄入量（g）
<51.001.00
≥52.51(1.52~4.15)*2.24(1.26~3.97)*
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影响疼痛和焦虑两维度的多因素分析［OR（95% CI）］

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特征疼痛或不舒服焦虑或沮丧
性别
男性1.001.00
女性1.33(0.92~1.92)1.74(1.14~2.66)*
年龄（岁）
<451.001.00
≥451.88(1.33~2.67)*1.04(0.71~1.53)
吸烟史
否1.001.00
是1.14(0.78~1.67)1.04(0.66~1.64)
服药史
否1.001.00
是1.49(0.99~2.25)0.99(0.59~1.64)
学历
小学及初中1.001.00
高中及以上0.50(0.32~0.78)*0.66(0.42~1.06)
患病情况
健康1.001.00
患有1种及以上CMD1.79(1.23~2.62)*1.57(1.02~2.43)*
肥胖（kg/m2）
BMI<281.001.00
BMI≥281.08(0.73~1.60)1.29(0.84~2.00)
盐摄入量（g）
<51.001.00
≥52.51(1.52~4.15)*2.24(1.26~3.97)*
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Analysis of factors associated with HRQoL

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变量健康效用值VAS得分
β(95%CI)P值β(95%CI)P值
女性(以男性为参照)0.016(-0.020~0.053)0.381-0.273(-1.739~1.192)0.715
年龄（以45岁以下人群为参照）-0.044(-0.080~-0.009)0.015-2.227(-3.601~-0.853)0.002
吸烟0.002(-0.036~0.040)0.9240.396(-1.125~1.917)0.610
服药-0.029(-0.076~0.019)0.237-3.716(-5.833~-1.600)<0.001
教育程度(以小学组为参照)
初中0.045(0.009~0.081)0.0140.192(-1.291~1.676)0.799
高中及以上0.095(0.049~0.141)<0.0012.273(0.561~3.985)0.009
患病情况（以健康组为参照）
单病组-0.034(-0.073~0.005)0.092-1.960(-3.557~-0.363)0.016
共病组-0.125(-0.187~-0.063)<0.001-4.686(-7.514~-1.859)0.001
肥胖-0.002(-0.042~0.038)0.930-1.341(-3.001~0.320)0.114
盐摄入量（g，以盐摄入量<5g组为参照）
5~<10-0.067(-0.114~-0.020)0.006-1.656(-3.290~-0.022)0.047
≥10-0.085(-0.133~-0.038)<0.001-1.432(-3.121~0.258)0.097
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HRQoL影响因素分析

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变量健康效用值VAS得分
β(95%CI)P值β(95%CI)P值
女性(以男性为参照)0.016(-0.020~0.053)0.381-0.273(-1.739~1.192)0.715
年龄（以45岁以下人群为参照）-0.044(-0.080~-0.009)0.015-2.227(-3.601~-0.853)0.002
吸烟0.002(-0.036~0.040)0.9240.396(-1.125~1.917)0.610
服药-0.029(-0.076~0.019)0.237-3.716(-5.833~-1.600)<0.001
教育程度(以小学组为参照)
初中0.045(0.009~0.081)0.0140.192(-1.291~1.676)0.799
高中及以上0.095(0.049~0.141)<0.0012.273(0.561~3.985)0.009
患病情况（以健康组为参照）
单病组-0.034(-0.073~0.005)0.092-1.960(-3.557~-0.363)0.016
共病组-0.125(-0.187~-0.063)<0.001-4.686(-7.514~-1.859)0.001
肥胖-0.002(-0.042~0.038)0.930-1.341(-3.001~0.320)0.114
盐摄入量（g，以盐摄入量<5g组为参照）
5~<10-0.067(-0.114~-0.020)0.006-1.656(-3.290~-0.022)0.047
≥10-0.085(-0.133~-0.038)<0.001-1.432(-3.121~0.258)0.097
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18～69岁成人健康相关生命质量现状及影响因素研究
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于欢 1 , 李晴 1 , 辛雨泽 2 , 刘敏 1 , 丹诗卓玛 2 , 田懋一 2 , 徐建伟 1
现代预防医学 | 流行病与统计方法 2026,53(3): 405-410
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现代预防医学 |流行病与统计方法 2026 , 53 (3) : 405 -410
18～69岁成人健康相关生命质量现状及影响因素研究
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于欢1, 李晴1, 辛雨泽2, 刘敏1, 丹诗卓玛2, 田懋一2, 徐建伟1
作者信息
  • 1.中国疾病预防控制中心慢性非传染性疾病预防控制中心健康促进与行为干预室，北京 100050
  • 2.哈尔滨医科大学公共卫生学院流行病学教研室
通讯作者:
徐建伟，E-mail:
作者简介:

于欢（2000—），女，硕士在读，研究方向：慢性病防控研究

Health-related quality of life and its influencing factors among adults aged 18-69 years
Huan YU1, Qing LI1, Yu-ze XIN2, Min LIU1, ZHUOMA Dan-shi2, Mao-yi TIAN2, Jian-wei XU1
Affiliations
  • Department of Health Promotion and Behavioral Intervention, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
出版时间: 2026-02-10 doi: 10.20043/j.cnki.MPM.202507090
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摘要
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目的

了解我国三省18～69岁成人健康相关生命质量现况及影响因素，为后续健康管理提供参考依据。

方法

基于2022—2023年开展的中国三省减盐行动评估项目，通过多阶段随机抽样抽取的1 440名18～69岁常驻居民为调查对象。使用欧洲五维健康量表（five-level EuroQoL five-dimensions, EQ-5D-5L）评估健康相关生命质量。采用Tobit回归、普通最小二乘法（ordinary least squares,OLS）回归分析得分的影响因素。

结果

本研究共纳入研究对象1 426名，健康效用值得分为1.00(-0.20, 1.00)，视觉模拟量表（visual analogue scale，VAS）得分为88(80, 94)，总体较好。Tobit回归分析结果显示，年龄≥45岁（β=-0.044, 95% CI：-0.080～-0.009）、初中（β=0.045, 95% CI：0.009～0.081）、高中及以上（β=0.095, 95% CI：0.049～0.141）、患共病（β=-0.125, 95% CI：-0.187～-0.063）、盐摄入量5～<10 g（β=-0.067, 95% CI：-0.114～-0.020）以及盐摄入量≥10 g（β=-0.085, 95% CI：-0.133～-0.038）对健康效用值产生显著影响（P<0.05）。OLS回归分析结果显示年龄≥45岁（β=-2.227, 95% CI：-3.601～-0.853）、高中及以上（β=2.273, 95% CI：0.561～3.985）、服药（β=-3.716, 95% CI：-5.833～-1.600）、患心血管代谢性疾病（β=-1.960, 95% CI：-3.557～-0.363）、患共病（β=-4.686, 95% CI：-7.514～-1.859）以及盐摄入量5～<10 g（β=-1.656, 95% CI：-3.290～-0.022）对VAS得分有显著影响（P<0.05）。

结论

研究对象健康相关生命质量总体较好，心血管代谢性共病患者的健康相关生命质量显著降低，在健康管理中应重视对共病的防治与管理，还应关注高龄、低学历、盐摄入过量的居民。

健康相关生命质量  /  EQ-5D-5L量表  /  Tobit回归
Objective

To investigate the health-related quality of life (HRQoL) and its determinants among adults aged 18-69 in three Chinese provinces, providing evidence for targeted health management strategies.

Methods

Based on the salt reduction action study conducted from 2022 to 2023 in three provinces of China, a total of 1 440 permanent residents aged 18-69 years were selected as survey participants through multi-stage random sampling. The Five-level EuroQoL five-dimensions (EQ-5D-5L) was used to assess health-related quality of life. Tobit regression and ordinary least squares (OLS) regression were employed to analyze factors influencing the utility scores.

Results

This study included a total of 1 426 participants. The health utility value was 1.00 (-0.20, 1.00), and the Visual Analogue Scale (VAS) score was 88 (80, 94), indicating a generally favorable health status. The Tobit regression analysis revealed that age ≥45 years (β=-0.044, 95% CI: -0.080~-0.009), junior high school education (β=0.045, 95% CI: 0.009-0.081), high school education or above (β=0.095, 95% CI: 0.049-0.141), comorbidities (β=-0.125, 95% CI: -0.187~-0.063), salt intake of 5~<10 g (β=-0.067, 95% CI: -0.114~-0.020), and salt intake ≥10 g (β=-0.085,95% CI: -0.133~-0.038) were significant determinants of health utility values (P<0.05). The OLS regression analysis indicated that age ≥45 years (β=-2.227, 95% CI: -3.601~-0.853), high school education or above (β=2.273, 95% CI: 0.561~3.985),medication use (β=-3.716, 95% CI: -5.833~-1.600), presence of cardiometabolic diseases (β=-1.960, 95% CI: -3.557~-0.363), comorbidities (β=-4.686, 95% CI: -7.514~-1.859), and salt intake of 5~<10g (β=-1.656, 95% CI: -3.290~-0.022)significantly influenced VAS scores (P<0.05).

Conclusion

The overall HRQoL among the study participants was generally favorable. However, HRQoL was significantly reduced in individuals with cardiometabolic multimorbidity. Hence, greater emphasis should be placed on the prevention and management of multimorbidity in health administration. Additionally, more attention is needed for residents who are of advanced age, have lower educational attainment, or consume excessive amounts of salt.

Health-related quality of life  /  EQ-5D-5L  /  Tobit model
于欢, 李晴, 辛雨泽, 刘敏, 丹诗卓玛, 田懋一, 徐建伟. 18～69岁成人健康相关生命质量现状及影响因素研究. 现代预防医学, 2026 , 53 (3) : 405 -410 . DOI: 10.20043/j.cnki.MPM.202507090
Huan YU, Qing LI, Yu-ze XIN, Min LIU, ZHUOMA Dan-shi, Mao-yi TIAN, Jian-wei XU. Health-related quality of life and its influencing factors among adults aged 18-69 years[J]. Modern Preventive Medicine, 2026 , 53 (3) : 405 -410 . DOI: 10.20043/j.cnki.MPM.202507090
正文
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健康相关生命质量（health-related quality of life,HRQoL）[1]是一种多维度的健康评价指标，通过量化个体在生理、心理和社会功能等领域的自我感知，综合反映其对整体健康状况和生活质量的主观评价。现有HRQoL研究多集中于单一慢性病或慢性病共病患者[2-3]，研究显示年龄、慢性病患病情况和生活方式等是重要的影响因素。但关于心血管代谢性疾病（cardiometabolic disease, CMD）以及盐摄入过量这一高血压危险因素对HRQoL影响的相关研究较少。本研究采用欧洲五维健康量表（five-level EuroQoL five-dimensions, ED-5D-5L）依托中国三省减盐行动评估项目，分析18～69岁成人HRQoL及影响因素，为了解HRQoL现状及开展后续健康管理等提供依据。
1　对象与方法
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1.1　研究对象
本研究基于2022—2023年开展的中国三省减盐行动评估项目的基线调查获得数据。通过多阶段随机抽样，在黑龙江、贵州及广东三个省份共6个县区随机选取8个村。每村按性别和年龄分层抽样，每村抽取30名18～69岁常驻居民，共计调查1 440人。孕妇、因身体原因无法做出知情同意、患有认知障碍、智力障碍或精神疾病等情况的居民以及尿液不合格者不纳入本研究，最终纳入1 426人。本研究通过中国疾病预防控制中心慢性非传染性疾病预防控制中心伦理委员审查（批号 202021）。调查对象均已签署知情同意书。
1.2　研究方法与资料收集
调查包括面对面问卷调查、体格测量、尿液标本收集与检测三个部分。调查内容：（1）一般情况：包括性别、年龄、受教育程度、吸烟史、服药史等基本信息以及糖尿病、缺血性心脏病等疾病史信息。（2）体格测量包括身高、体重、血压等基础指标。血压测量严格遵守规范流程。（3）盐摄入量：通过24 h尿钠法进行计算。收集24 h尿液样本，完成后，由工作人员将尿液混匀，随后采集2 ml于试管中，后在冷链状态下运往指定的第三方检测机构。检测结果包括尿钠及尿肌酐等。（4）HRQoL测量：采用EQ-5D-5L量表，该量表由EQ-5D描述系统和EQ-5D视觉模拟量表（visual analogue scale, VAS）两部分组成。前者包括行动能力、自我照顾、日常活动、疼痛或不舒服、焦虑或沮丧五个维度，每维度分为没有困难、有一点困难、有中度的困难、有严重困难和无法进行或有非常严重的困难五个水平，利用基于中国人群的积分体系[4]计算健康效用值，计算公式为1减去各个维度对应的权重之和，所得差值即为健康效用值，取值范围为-0.391～1.000。VAS得分范围为0～100分，0分代表“最差的健康状态”，100分代表“最好的健康状态”，由受试者根据自身健康状况标记相应分值。Tobit模型，又称删失回归模型，适用于处理因变量在某个临界值处存在聚集的情况[5]。
1.3　诊断标准及定义
（1）高血压[6]定义为既往有高血压病史正服用降压药或在未使用降压药的情况下，收缩压≥140 mmHg或舒张压≥90mm Hg。（2）肥胖[7]定义为身体质量指数（body mass index,BMI）≥28 kg/m2，计算公式为体重（kg）/身高的二次方（m）2。（3）24 h尿液收集不合格[8]定义为24 h尿量<500 ml、留尿时间不足20 h或超过28 h、男性尿肌酐<6 mmol/女性尿肌酐<4 mmol。（4）心血管疾病定义为自报有医院诊断的短暂性脑缺血、缺血性心脏病、充血性心力衰竭、外周动脉疾病中的一种及以上。（5）CMD[9]定义为患高血压、糖尿病或冠心病等。（6）心血管代谢性疾病共病（cardiometabolic multimorbidity, CMM）[10]定义为患有高血压、糖尿病、心血管疾病三种中的两种及以上。其中高血压、肥胖根据测量数据获得，其它病史均通过调查对象自报获得。
1.4　统计学分析
使用SAS 9.4软件进行数据清理和分析。不服从正态分布的定量资料用中位数与四分位数描述，用例数和构成比描述计数资料，组间比较采用非参数检验。用二元logistic回归分析在不同维度下是否存在健康问题与各变量间的关系。用Tobit回归分析健康效用值影响因素，用普通最小二乘法（ordinary least squares,OLS）回归分析VAS得分的影响因素。检验水准α=0.05。
2　结果
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2.1　研究对象HRQoL比较
本研究共纳入研究对象1 426名，平均年龄为(45.05±12.37)岁，其中男性722名，占50.63%。研究对象健康效用值［M（P25，P75）］为1.00(-0.20, 1.00)，其中有80%研究者的效用值为1，VAS得分［M（P25，P75）］为88(80, 94)。不同年龄、服药情况、受教育程度、患病情况、肥胖、盐摄入量的健康效用值及VAS得分差异有统计学意义。见表1。
2.2　研究对象HRQoL情况
结合EQ-5D-5L量表的调查结果，按照存在困难（包括有一点困难、中度困难、严重困难以及非常严重的困难）从高到低的比例排序分别是疼痛或不舒服（15.63%）、焦虑或沮丧（10.66%）、行动能力（1.68%）、日常活动（1.05%）和自我照顾（0.56%）。由于在另外三个维度有问题的人数占比较少，因此对疼痛或不舒服及焦虑或沮丧维度的有困难情况进行进一步分析，疼痛或不舒服维度在不同年龄、服药史、学历、患病情况及盐摄入量组间分布差异具有统计学意义，焦虑或抑郁维度在不同性别、服药史、学历、患病情况及盐摄入量组间分布差异具有统计学意义，见表2。以是否存在困难作为因变量，使用二元logistic回归对疼痛或不舒服及焦虑或沮丧维度的影响因素进行深入分析，疼痛或不舒服维度的影响因素包括年龄、学历、患病情况及盐摄入量；在焦虑或抑郁维度性别、服药史、学历、患病及盐摄入量是其影响因素。见表3。
2.3　研究对象HRQoL影响因素分析
以换算后健康效用值为因变量，以性别、年龄、吸烟史、服药史、教育程度、患病情况、肥胖情况、盐摄入量为自变量进行Tobit回归分析。Tobit回归分析结果表明，年龄与健康效用值呈负相关，而教育程度、良好健康状况及低盐摄入量均与健康效用值呈正相关。具体而言，年龄低于45岁、拥有小学以上学历、健康状况良好以及低盐摄入的个体，其健康效用值显著更高。OLS回归分析以VAS自评得分作为因变量，以性别、年龄、吸烟史、服药史、教育程度、患病情况、肥胖、盐摄入量作为自变量，分析结果显示年龄及服药与VAS得分呈负相关，而教育程度、良好健康状况及低盐摄入量与VAS得分呈正相关，即年龄低于45岁、不服药、拥有高中及以上学历、健康状况良好以及低盐摄入者VAS得分显著更高。见表4。
3　讨论
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本研究采用EQ-5D-5L量表测量HRQoL，结果显示健康效用值［M（P25，P75）］为1.00(-0.20, 1.00)，VAS得分［M（P25，P75）］为88(80, 94)。为与其他研究比较，同时计算了两者平均值与标准差分别为(0.977±0.069)、(84.635±11.891)。Li等人[11]利用多省份数据建立的中国五维人群常模的健康效用值与VAS得分分别为(0.94±0.14)、(73.4±21.6)。与之相比，研究者HRQoL总体较好。
在维度分析方面，多项研究显示我国人群HRQoL主要受疼痛或不适以及焦虑或抑郁影响[12-13]，这与本研究结果一致。在本研究中，疼痛或不舒服（15.63%）和焦虑或沮丧（10.66%）问题报告率最高，提示在居民健康管理中应特别关注躯体感觉和情绪状态等主观健康体验。而自我照顾能力维度问题报告率最低（0.56%），可能与研究对象患病严重程度较轻未影响自理能力有关[14]。在疼痛或不舒服维度，问题的发生与年龄、教育程度、患病情况以及盐摄入量有关。而焦虑或沮丧维度，问题的发生与性别、疾病以及盐摄入量有关。两维度的深入分析结果均提示要提高主观健康体验应从生理、行为等多方面进行干预，对低学历、患者、高盐饮食者等高风险人群进行综合干预，以实现综合防控。
在影响因素研究方面，现有分析方法多使用Tobit回归、logistic回归以及多重线性回归等，研究的影响因素多聚焦于性别、年龄、文化程度、婚姻状态、工作与收入等人口学特征，烟酒、运动等生活行为以及医保、就诊、慢性病患病情况等医疗健康相关指标。多项研究采用EQ-5D系列量表对不同人群进行了HRQoL的影响因素分析，结果具有较高一致性。多项研究表明高龄、女性、低学历、低收入、吸烟、缺乏锻炼等不良生活方式以及高血压、糖尿病、肥胖等慢性病患病是HRQoL降低的主要危险因素[15-18]。同时，有研究还发现社会活动和养老保险可能会对HRQoL产生保护作用[19]。因本研究根据积分体系计算的健康效用值聚集于1存在天花板效应，所以用Tobit回归分析健康效用值影响因素。在本研究中不同性别间健康效用值及VAS得分差异无统计学意义，与先前的结论有所不同，但在Li等人[11]的研究中也得到了HRQoL性别差异不显著的结果，这可能为在健康方面性别差距趋于缩小提供了线索。此外，本研究Tobit分析结果显示年龄低于45岁、小学及以上学历者健康效用值更高，而CMM患者的健康效用值显著降低。OLS回归分析显示年龄低于45岁、无服药史、拥有高中学历及以上者自评VAS得分更高，患CMD、CMM者自评VAS得分更低，这提示CMD、CMM会影响居民的HRQoL，在后续管理中应注意预防共病的发生。但在本研究结果中肥胖对健康效用值及VAS得分的影响并不显著，这可能与研究人群特征以及纳入的影响变量不同有关。
在生活因素方面，因既往研究多聚焦烟酒、运动等，而对盐摄入过量这一健康危险因素的关注相对较少，故本研究特别关注了盐摄入量对HRQoL的影响。通过尿液检测得到较为准确的盐摄入量数据，分析提示低盐摄入是提高健康效用值的有效因素。但VAS得分中盐摄入量的影响较为复杂，与低盐组相比，盐摄入量在5～10g组的VAS得分较低，但盐摄入≥10g组VAS得分差异无显著性，可能与受试者的自我认知偏差有关。该组中有73.24%的受试者认为自己的盐摄入量“正好”，表明其可能未意识到盐摄入偏高的现状，从而未能反应高盐摄入的真实影响。结合相关文献[20]，盐摄入可能会通过诱发高血压、血管功能障碍、系统性炎症及交感神经兴奋等机制影响健康，从而影响HRQoL。但由于本研究缺乏对血压控制情况、系统性炎症生物标志物等指标数据，因此尚不能深入实证上述机制，未来研究需纳入这些关键指标以提供更全面的证据。此外，调查结果显示低盐饮食者占比仅为19.14%，比例较低，这提示在实际生活中仍需加强对减盐的宣传和干预以促进减盐行为。
本研究属于横断面研究，无法阐明影响因素之间的关系。同时由于对疾病严重程度这一潜在影响因素未加以控制，可能对维度分析尤其是自我照顾维度分析不够深入。此外，高盐摄入导致HRQoL的作用机制还不能阐明，需要后续收集更详细的资料进行分析。
综上所述，本研究发现CMM及盐摄入量会影响居民的HRQoL。此外，年龄、学历等也会对HRQoL产生显著影响。改善HRQoL既要加强疾病管理，又要重视盐摄入等生活方式转变。未来研究可进一步探索影响因素的人群特异性，为制定精准化健康干预措施提供依据。
基金
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  • 四大慢病重大专项(2024ZD0524600)
  • 澳大利亚国家健康与医学研究理事会以及全球慢性疾病合作联盟资助(APP1169751)
文献
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2026年第53卷第3期
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doi: 10.20043/j.cnki.MPM.202507090
  • 接收时间：2025-07-09
  • 首发时间：2026-11-02
  • 出版时间：2026-02-10
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  • 收稿日期：2025-07-09
基金
四大慢病重大专项(2024ZD0524600)
澳大利亚国家健康与医学研究理事会以及全球慢性疾病合作联盟资助(APP1169751)
作者信息
    1.中国疾病预防控制中心慢性非传染性疾病预防控制中心健康促进与行为干预室，北京 100050
    2.哈尔滨医科大学公共卫生学院流行病学教研室

通讯作者:

徐建伟，E-mail:
参考文献
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202507090
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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