帕罗西汀对糖尿病前期伴焦虑抑郁患者血糖及内分泌的影响  

The Influence of Paroxetine on Blood Sugar and Endocrine of Pre-diabetes Patients Associated with Anxiety and Depression

作　　者：付晓倩[1] 董再全[1] 李西荣[2] 张岚[1] 唐雷[3] 张旭[1] 张耀尹[1] 蒋富贵[1] 李佳琦[4] 余叶蓉[4] 孙学礼[1] 

机构地区：[1]四川大学华西医院心理卫生中心,成都610041 [2]重庆医科大学附属第一医院精神科 [3]川北医学院附属医院精神科 [4]四川大学华西医院内分泌科

出　　处：《华西医学》2014年第4期669-671,共3页West China Medical Journal

基　　金：科技部"十一五"科技支撑项目(2009BAI77B06)~~

摘　　要：目的探讨抗焦虑药物帕罗西汀对糖尿病前期伴焦虑、抑郁患者血糖水平的影响及其与下丘脑-垂体-肾上腺皮质轴(HPA)的相关性。方法 2010年1月-2012年12月收集糖尿病前期且伴有焦虑抑郁的患者54例,行焦虑自评量表(SAS)、抑郁自评量表(SDS)问卷调查,口服葡萄糖耐量试验(OGTT)及内分泌测试,给予帕罗西汀治疗24周后再次进行上述测试。结果治疗24周后,患者焦虑抑郁水平、OGTT 0.5 h血糖、OGTT 1 h血糖、OGTT 2 h血糖、糖化血红蛋白(HbA1c)、促肾上腺皮质激素(ACTH)、血浆皮质醇水平均较治疗前明显下降,差异有统计学意义(P<0.05)。治疗前ACTH、血浆皮质醇水平与HbA1c呈正相关。治疗后ACTH减分率、血浆皮质醇减分率分别与HbA1c减分率、SAS减分率、SDS减分率呈正相关。结论抗焦虑(抑郁)治疗可显著降低糖尿病前期伴焦虑、抑郁患者的血糖水平,其作用机制可能与HPA轴功能活性有关。Objective To explore the association between paroxetine （Seroxat） and level of blood sugar and endocrine hormones in pre-diabetes patients with anxiety and depression. Methods Fifty-four pre-diabetes patients with anxiety and depression diagnosed from January 2010 to December 2012 were recruited. The self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were used to assess depression and anxiety. All the patients were treated by paroxetine. The glucose tolerance test （OGTT）, ACTH and cortisol were tested in patients at baseline and within 24 weeks. Results After 24 weeks＇ treatment, the level of anxiety and depression as well as the OGTT 0.5 h （0.5 h PG）, OGTT 1 h （1 h PG）, OGTT 2 h （2 h PG）, glycated hemoglobin （HbAlc）, adrenocorticotropic hormone （ACTH） and cortisol were significantly decreased （P 〈 0.05 or P 〈 0.01）. The glycated HbAlc had a positive correlation with adrenocorticotropic hormone （ACTH） and cortisol （F）. Before and after treatment, the reduced rate of ACTH and reduced rate of cortisol respectively exhibited a positive correlation with the reduced rate of HbA 1 c, reduced rate of SAS and reduced rate of SDS. Conclusion Anti-anxiety depression treatment can lower blood sugar level in pre-diabetes patients with anxiety and depression significantly, which may be related to the activity of HPA axis.

关 键 词：糖尿病前期 焦虑 抑郁 帕罗西汀 下丘脑-垂体-肾上腺皮质轴 

分 类 号：R587.2[医药卫生—内分泌] R749.4[医药卫生—内科学]