血糖变异性对老年伴糖尿病患者急性脑梗死后3个月抑郁的影响  

Effect of glycemic variability on depression 3 months following acute ischemic stroke in elderly diabetes mellitus patients

作　　者：吴硕琳[1] 余苹[2] 张宁[1] 周淑杰[1] 王春雪[1] WU Shuo-lin YU Ping ZHANG Ning et al(Department of Neuropsychiatry and Clinical Psychology ,Affiliated Beijing Tiantan Hospital of Capital Medical University ,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院神经精神医学与临床心理科,100050 [2]首都医科大学

出　　处：《中华老年心脑血管病杂志》2017年第3期284-287,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市科学技术委员会资助项目(Z151100004015127;Z151100003915117);首都医科大学附属北京天坛医院青年基金课题(2014-YQN-YS-11)

摘　　要：目的探讨血糖变异性(GV)对老年伴糖尿病患者急性脑梗死后3个月抑郁的相关性。方法连续纳入2014年8月~2015年8月在首都医科大学附属北京天坛医院神经病学中心及老年病科接受治疗的年龄≥65岁急性脑梗死患者50例。分为抑郁组23例,无抑郁组27例,所有患者通过口服葡萄糖耐量试验诊断糖尿病或既往明确诊断为糖尿病,随访3个月后采用健康问卷抑郁量表进行抑郁评估,运用logistic回归分析GV与急性脑梗死后3个月抑郁的关系。结果抑郁组患者的糖尿病病程、GV四分位间距、入院时美国国立卫生研究院卒中量表(NIHSS)评分≥9分、额叶梗死的比例显著高于无抑郁组,差异有统计学意义(P=0.000)。多因素logistic回归分析显示,GV≥30%脑梗死后抑郁发生风险为GV<16%的3.96倍(95%CI:1.01~18.53,P=0.047)。入院时NIHSS评分≥9分的患者,发生脑梗死后3个月抑郁的风险为入院时NIHSS评分<9分患者的2.28倍(95%CI:1.05~19.86,P=0.039)。结论 GV水平增高可以加重老年伴糖尿病患者急性脑梗死后3个月抑郁发生的风险。Objective To study the effect of glycemic variability（GV）on depression 3months following acute ischemic stroke（AIS）in elderly diabetes mellitus（DM）patients.Methods Fifty≥65years old AIS patients admitted to our hospital from August 2014 to August 2015 were divided into depression group（n=23）and depression-free group（n=27）.The patients were diagnosed with DM and followed up for 3months,during which their depression was assessed according to the PHQ-9.The relationship between GV and depression 3months following AIS was analyzed by logistic regression analysis.Results The course of DM and the distance between quartile GV were significantly longer,the NIHSS score and the incidence of frontal lobe infarction were significantly higher in depression group than in depression-free group（P=0.000）.Multivariate logistic regression analysis showed that the risk to develop depression following AIS was 3.96-fold higher in GV≥30% patients than in GV〈16% patients（95%CI：1.01-18.53,P=0.047）and was2.28-fold higher in AIS patients with their NIHSS score≥9on admission than in those with their NIHSS score〉9on admission（95%CI：1.05-19.86,P=0.039）.Conclusion Elevated GV increases the risk to develop depression 3months following AIS in elderly DM patients.

关 键 词：血糖 糖尿病 脑梗死 抑郁 

分 类 号：R743.33[医药卫生—神经病学与精神病学]