江苏省2型糖尿病患者并发抑郁状态与治疗方式的相关分析  

Correlation analysis of depression and treatments in type 2 diabetes mellitus in Jiangsu Province

作　　者：刘慧[1] 毕艳[2] 朱大龙[2] 缪小萍[2] 

机构地区：[1]南京大学医学院附属鼓楼医院内分泌科,210008 [2]江苏扬州市第一人民医院内分泌科

出　　处：《中华糖尿病杂志》2014年第10期717-720,共4页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金（30800539、81070636）;江苏省科技发展项目（BK2010110）;南京市医学科技发展重点项目（ZKX09024）

摘　　要：目的 研究江苏省2型糖尿病患者抑郁状态及其严重程度与治疗方案的关系.方法 2009年7月对2 953例2型糖尿病患者采用横断面调查方法,调查以问卷形式为主,收集患者一般情况、病程、抑郁量表评分、治疗和并发症发生情况等,并检测患者糖化血红蛋白（HbA1c）.选取符合条件的调查样本2 741例进行分析.抑郁评分采用Beck抑郁问卷进行,抑郁分组：≤4分为非抑郁组;5～13分为轻度抑郁组;14～20分为中度抑郁组;＞20分为重度抑郁组.应用logistic回归对抑郁相关因素进行统计分析. 结果 本次调查中2型糖尿病患者并发抑郁症的发生率为51.1％（1 401例）,其中轻度抑郁1 034例（37.7％）,中度抑郁组234例（8.5％）,重度抑郁133例（4.9％）.与非抑郁组相比,抑郁组的女性比例较高（55.9％比44.7％,χ^2=34.65）,年龄较轻[（56±11）比（57±11）岁,t=2.80],高血压患病率（46.3％比40.4％,χ^2=9.63）、并发症发生率（39.5％比29.2％,χ^2=32.12）及接受糖尿病教育患者比例（46.8％比38.7％,χ^2=18.32）比例均较高（均P＜0.05）.患者性别、糖尿病教育、并发症、治疗方式与抑郁症发生有相关性（OR=0.65、1.21、1.41、1.15,均P＜0.05）,未发现HbA1c与抑郁发生率有相关性.单药治疗组中,二甲双胍治疗组抑郁发生率最低（42.9％）.三种及以上用药者的中重度抑郁分布明显高于单种和两种用药者（分别为20.1％、10.1％、10.4％,χ^2=12.08、12.98,均P＜0.05）.结论 2型糖尿病患者的抑郁状态发生率较高,性别、糖尿病教育、并发症、治疗方式与糖尿病并发抑郁状态有相关性.Objective To investigate the relation between the treatment of diabetes and the depression in type 2 diabetes mellitus in Jiangsu Province.Methods All 2 953 outpatients with type 2 diabetes were surveyed with questionnaire in July 2009.The main content of the questionnaire included the demographic and metabolic data and diabetes-related health behaviors.Blood samples of the patients were collected for the assessment of glycated hemoglobin A1c（HbA1c）.Diagnosis of depression（Beck depression scale）：≤4 points,no depression; 5-13 points,mild depression; 14-20 points,moderate depression; 21 points or higher,severe depression.The logistic regression analysis was used in analysis of related factors of depression.Results Total of 2 741 cases were qualified for data analysis.The overall incidence of depression in the type 2 diabetics was 51.1%（1 401 cases）,including 37.7%（1 034 cases） with mild,8.5% （234 cases） with moderate and 4.9% （133 cases） with severe depression.Compared with those in patients without depression,the female gender rate（55.9% vs 44.7%）,diabetes education rate（46.8% vs 38.7%）,hypertension rate（46.3% vs 40.4%）,diabetes complications rate（39.5% vs 29.2%） in patients with depression were all significantly higher（χ^2=34.65,18.32,9.63,32.12,all P〈0.05）,and the patients were also younger（（56±1 1） vs （57±11） years,t=2.80,P〈0.05）.Logistic regression analysis revealed that female gender （OR=0.65）,diabetes education （OR=1.21）,diabetes treatments （OR=1.41） and complications （OR=1.15） were associated with depression（all P〈0.05）,no correlation was found between HbA1c and depression.The depression incidence in metformin group （42.9%） was the lowest in the patients treated with single agent.The incidence of moderate and severe depression in the patient treated with three kinds of agents was higher than those in patients treatd with single and two agents （20.1%,10.1%,10.4%,respectively; χ^2=12.08,12.98,both P〈0.05）.Concl

关 键 词：糖尿病 2型 抑郁 相关分析 

分 类 号：R587.1[医药卫生—内分泌]