摘要
目的 调查 2型糖尿病 (T2DM)患者抑郁症存在情况及其产生原因。 方法 对 16 2例T2DM患者进行糖尿病 (DM )及其并发症相关的检查后 ,就DM对其本人心理状态影响的因素及影响程度进行问卷调查 ,应用SDS抑郁自评量表评价抑郁情况 ,分析抑郁与DM患者的心理影响因素及治疗情况之间的关系。 结果 6 1 7%的患者无抑郁表现。 38 3%的患者存在不同程度的抑郁症 ,其中轻度 2 0 4 % ,中度 13 6 % ,重度 4 3%。与无抑郁症的DM患者比较 ,DM合并抑郁症的患者病程长 (8 5± 6 8年 ,4 8± 6 3年 ,P <0 0 0 1) ,餐后 2h血糖 (16 3± 9 1mmol/L ,13 0± 94 7mmol/L ,P <0 0 1)及 2 4小时尿白蛋白 (17 7± 2 0 7mg、11 2± 10 2mg ,P <0 0 5 )明显升高 ,踝关节音叉震动觉时间明显缩短 (8 5± 4 8s ,10 7± 3 6s,p <0 0 5 )。DM患者的抑郁程度又分别与下列因素呈正相关 :DM并发症 (r =0 2 6 7,P <0 0 1)、运动治疗 (r =0 2 6 1,P <0 0 1)、DM无法根治 (r =0 182 ,P <0 0 5 )、服药麻烦 (r =0 178,P <0 0 5 )以及饮食控制 (r =0 15 7,P <0 0 5 )、DM病程 (r =0 2 2 5 ,P <0 0 1)、尿白蛋白 (r =0 16 3,P <0 0 5 )、HbA1c(r =0 15 7,P <0 0 5 ) ;与踝关节音叉震动觉时间(r =- 0 16 4 。
Objective To investigate depression and its risk factors, and improve the prevention and management of depression in type 2 diabetes(T2DM). Methods SDS(Self-rating Depression Scale) were used to evaluate the depression in 162 T2DM patients (male 88,female 74). The relationship of depression with diabetic complications, blood glucose control and the treatment compliance were analyzed. Results 61.7% patients had no depression, 38.3% patients had depression, including 20.4% with mild, 13.6% with moderate, and 4.3% with severe depression. The risk factors for depression were the possibility of diabetes complications, the fare of treatment, no method to cure the disease, worry about insulin injection and the transmissibility. The duration of diabetes with depression were significantly longer(8.5±6.8 y vs 4.8±6.3 y,P<0.001),both postprandial serum glucose levels (16.3±9.1 mmol/L vs 13.0±94.7 mmol/L,P<0.01) and 24 hour’s urine albumin (17.7±20.7 mg vs 11.2±10.2 mg,P<0.05) was significantly higher,whereas the time of shaking feeling in the ankles by turning fork was significantly shorter (8.5±4.8 s vs 10.7±3.6 s, P<0.05.) The depression was positively correlated with the worry on diabetic complications (r=0.267, P<0.01) , exercise (r=0.261,P<0.01), no special method to cure diabetes (r=0.182,P<0.05), economic burden of the diabetes treatment (r=0.178, P<0.05), and the complicated diet therapy (r=157, P<0.05), also with the duration of diabetes(r=0.225,P<0.01), urine albumin excretion rate(0.163,P<0.05),HbA 1c (r=0.157,P<0.05) and negatively correlated with the time of shaking feeling in the ankles by turning fork (r=-0.164,P<0.05). Conclusion As high as 38.3% diabetic patients of this group have depression , which is related with worry on complicated diabetic therapy , with blood glucose control, diabetic complications and duration of diabetes. Proposing the healthy life style, prevention of the diabetic complication, and finding the simple ways of treatment for diabetes are very important for the prevention and management of depression in type 2 diabetes.
