糖尿病合并抑郁症的临床研究  

Clinical Study of Diabetes Mellitus Complicated with Depression

作　　者：章伟明[1] 王素梅[1] 刘一鸣[1] 王叶青[1] 员凤英[1] 李赛美[2] 

机构地区：[1]广东药学院附属第一医院,广东广州510080 [2]广州中医药大学,广东广州510405

出　　处：《广州中医药大学学报》2013年第5期619-623,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省建设中医药强省科研立项资助课题(编号:2009241)

摘　　要：【目的】通过对糖尿病合并抑郁症与糖尿病非抑郁症2组相关临床资料的比较,探讨抑郁症对糖尿病患者的影响,并初步探讨糖尿病合并抑郁症的相关生物学机制。【方法】通过对168例糖尿病患者进行汉密尔顿抑郁量表测评、临床资料收集及统计,探讨糖尿病合并抑郁症患者与糖尿病非抑郁症患者在年龄、性别、体质量指数(BMI)、病程、血糖、糖化血红蛋白、血脂及C肽、睾酮(T)、皮质醇(COR)、雌激素(E2)等因素的相关性。【结果】糖尿病抑郁症组较糖尿病非抑郁症组体质量指数低、病程长、汉密尔顿量表评分值高,差异有统计学意义(P<0.05或P<0.01);2组的平均年龄、糖化血红蛋白、空腹血糖、餐后2 h血糖、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白差异无统计学意义(P>0.05)。糖尿病抑郁症组较糖尿病非抑郁症组COR值高,餐前基础C肽、餐后2 h C肽值低。就男性而言,抑郁症组T值水平低而E2水平高,而女性患者T值水平高而E2水平低。2组比较仅餐前C肽、E2水平差异有统计学意义(P<0.05),COR值、餐后2 h C肽值、T值等差异无统计学意义(P>0.05)。【结论】在强化糖尿病治疗的前提下,糖尿病合并抑郁症较糖尿病非抑郁症患者生化指标差异不大,但对其HPA轴系统、下丘脑—垂体—性腺轴稳定性有更大影响。Objective The clinical data of diabetes mellitus patients with or without the complication of depression was compared to investigate the influence of depression on the development of diabetes mellitus and to explore its biological mechanism. Methods Clinical data and Hamilton Depression Rating Scale （HDRS） scores of 168 diabetes mellitus patients were collected for the investigation of the correlation of depression- complicated or non-depression-complicated diabetes mellitus with the age, gender, body mass index （BMI）, course of disease, blood glucose, glycosylated hemoglobin, blood lipid, C-peptide, testosterone （T） , hydrocortisone （COR）, estrogen （E2）. Results Depression-complicated diabetes mellitus patients had lower BMI, longer disease course and higher HDRS scores than non-depression-complicated diabetes mellitus patients （P 〈0.05）, but the differences of mean age, glycosylated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, triglyceride, high-density lipoprotein and low-density lipoprotein were insignificant （P〉0.05）. Depression-complicated diabetes mellitus patients had higher COR and lower preprandial and 2-hour postprandial C-peptide than non-depression-complicated diabetes mellitus patients, but only the difference of 2-hour postprandial C-peptide was signficiant （P〈0.05） . The male patients had lower T level and higher E2 level than the female, but only E2 had significant difference （P〈0.05）. Conclusion Depression-complicated diabetes mellitus patients have no obvious differences in biochemical indicators with non-depression-complicated patients, but have obvious differences in hypothalamic-pituitary-adrenocortical axis and hypothalamic-pituitary- gonadal axis.

关 键 词：糖尿病 抑郁症 生化指标 生物学机制 

分 类 号：R749.4[医药卫生—神经病学与精神病学]