| 伍丽霞,费扬帆,李爱平,等.老年2型糖尿病血糖控制不佳患者合并抑郁情况及胰岛素干预效果研究[J].安徽医药,2017,21(10):1895-1899. |
| 老年2型糖尿病血糖控制不佳患者合并抑郁情况及胰岛素干预效果研究 |
| A study for depression situation of elderly type 2 diabetes with poor glycemic and the effect of insulin intervention WU Lixia,FEI Yangfan,LI Aiping,ZHAO Li,HUANG Lingyi (Department of Endocrinology,People′s Hospital of Meishan City,Meishan,Sichuan 620020,China) Abstract:Objective |
| 投稿时间：2016-09-11 |
| DOI： |
| 中文关键词: 2型糖尿病 抑郁 糖化血红蛋白 血糖控制 胰岛素 |
| 英文关键词: Type 2 diabetes mellitus Depression Glycosylated hemoglobin Blood glucose control Insulin |
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| 摘要点击次数: 2570 |
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| 中文摘要: |
| 目的 探讨老年2型糖尿病(T2DM)患者血糖控制状况与抑郁之间的关系,分析胰岛素干预对患者抑郁症改善的效果。 方法 以167例血糖控制不佳的老年T2DM患者为研究对象,根据汉密尔顿抑郁量表(HRSD)评分是否＞17分将患者分为抑郁组(80例)和非抑郁组(87例),两组均在原来口服药物治疗的基础上给予胰岛素,记录两组治疗前后糖化血红蛋白(HbA1C)、HRSD评分以及皮质醇(Cor)水平改善情况,并分析干预后血糖控制达标与抑郁改善之间的关系。 结果 两组治疗后HRSD评分、HbA1C水平以及Cor水平均出现下降趋势,前后比较均差异有统计学意义(P<0.05),非抑郁组上述三个指标在不同节点上和抑郁组比较也均差异有统计学意义(P<0.05)。两组血糖达标率随着胰岛素干预时间延长呈明显上升趋势,6个月后HbA1C<7%者分别达到66.3%和86.2%,组间比较差异有统计学意义(P<0.05)。治疗前所有患者中抑郁和非抑郁比例为1∶1.1(80/87),治疗6个月后比例为1∶4.6(30/137),治疗前后抑郁程度差异有统计学意义(P<0.05)。治疗6个月后患者抑郁情况与血糖控制是否达标中度相关(r=0.442,P<0.05)。 结论 血糖控制不佳的老年T2DM患者抑郁发生率较高,程度较严重,胰岛素干预可明显降低患者HbA1C水平,改善患者抑郁状态,临床诊治该类患者要考虑抑郁对血糖控制的影响,尽早使用胰岛素干预。 |
| 英文摘要: |
| Objective To investigate the relationship between blood glucose control and depression in elderly patients with type 2 diabetes mellitus (T2DM)and analyze the effect of insulin intervention on the improvement of depression. Methods 167 cases of elderly type 2 diabetes mellitus (T2DM) patients with poor blood glucose control as the research object were classified into depression group (80 cases) and non-depression group (87 cases) according to whether the Hamilton score of Depression (HRSD) was more than 17.Two groups were treated with insulin on the basis of the oral drug treatment and Glycosylated hemoglobin (HbA1C),HRSD score,cortisol (COR) before and after treatment in the two groups were recorded and the relationship between controlling status of blood glucose after intervention and depression improving were analyzed. Results After treatment,HRSD score,HbA1C levels and cortisol levels in two groups were decreased,and the difference before and after the treatment were statistically significant (P<0.05),and the differences of above three indicators in different nodes between two groups were also statistically significant (P<0.05).The blood glucose compliance rate of two groups showed a significant upward trend with prolong of insulin intervention,and patients with HbA1C statue reached 7% were 66.3% and 86.2% respectively after 6 months,the difference was statistically significant (P<0.05).Before treatment,the patients ratio of depression and non-depression was 1∶1.1 (80/87),and after 6 months of treatment,it decreased to 1∶4.6 (30/137),the difference before and after treatment was statistically significant (P<0.05).After treatment,the depression statue of patients and blood glucose control were moderately correlated (r= 0.442,P<0.05). Conclusions The incidence of depression in elderly T2DM patients with poor glucose control is high with serious degree.Insulin intervention can significantly reduce HbA1C level,and improve the depressive state of patients.In the diagnosis and treatment of such type of patients,we should take in consider of the effect of depression on glycemic control and use insulin early. |
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