1型糖尿病和2型糖尿病患者低血糖恐惧感和生活质量的比较研究  

A comparative study on the fear of hypoglycemia and quality of life in patients with type 1 and type 2 diabetes mellitus

作　　者：穆纯 许洪梅 包頔 张福莲[4] 翟仰魁 邢秋玲[5] Mu Chun;Xu Hongmei;Bao Di;Zhang Fulian;Zhai Yangkui;Xing Qiuling(National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Department of Ophthalmology,Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Department of Nursing,Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Department of Infection,Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Department of Integrated Traditional Chinese Medicine&Western Medicine,Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;National Health Commission Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Department of Medical Record,Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China)

机构地区：[1]天津医科大学朱宪彝纪念医院眼科,天津市内分泌研究所,国家卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,300134 [2]天津医科大学朱宪彝纪念医院护理部,天津市内分泌研究所,国家卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,300134 [3]天津医科大学朱宪彝纪念医院感染科,天津市内分泌研究所,国家卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,300134 [4]天津医科大学朱宪彝纪念医院中西医结合科,天津市内分泌研究所,国家卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,300134 [5]天津医科大学朱宪彝纪念医院病案科,天津市内分泌研究所,国家卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,300134

出　　处：《中华糖尿病杂志》2021年第2期139-144,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：天津医科大学朱宪彝纪念医院科研基金(2018ZDKF13)。

摘　　要：目的比较1型糖尿病(T1DM)和2型糖尿病(T2DM)患者低血糖恐惧感和生活质量的差异。方法采用多中心目的抽样方法选取2019年2至8月于天津市三家三级医院内分泌科就医的T1DM(21例)和T2DM(269例)患者作为研究对象,其中男156例(53.8%),女134例(46.2%),年龄(55.12±9.54)岁。对纳入的研究对象进行问卷调查。问卷包括一般资料调查表、中文版低血糖恐惧-忧虑量表(CHFSII-WS)、健康生活质量调查量表(SF-36)和世界卫生组织五项身心健康指标(WHO-5)。计量资料比较采用Kruskal Wallis H检验或Mann-Whitney U检验,多组间比较采用单因素方差分析。计数资料的比较采用χ^(2)检验。采用多元线性回归分析方法进行多因素分析。结果T1DM与T2DM患者低血糖频次及低血糖类型的差异具有统计学意义(χ^(2)=80.648,P<0.05;χ^(2)=118.856,P<0.05)。T1DM与T2DM患者CHFSⅡ-WS、WHO-5、SF-36中的生理功能(PF)、躯体疼痛(BF)、总体健康(GH)、社会功能(SF)、情感职能(RE)、心理健康(MH)、健康变化(HT)维度评分差异具有统计学意义(均P<0.05)。经历不同类型低血糖症状的糖尿病患者在CHFSⅡ-WS、SF-36的PF、SF、HT维度评分差异具有统计学意义(均P<0.05)。多元线性回归分析显示,糖尿病分型、WHO-5评分、性别、精神健康、定期监测血糖、经济情况为低血糖恐惧感的独立影响因素(偏回归系数为-1.621、0.027、0.407、-0.010、0.479、-0.226,均P<0.05)。结论T1DM患者的低血糖频率、严重程度和恐惧感程度比T2DM患者更高。低血糖在增加低血糖恐惧感的同时还对患者的生活质量及心理健康产生影响。Objective To investigate the difference of fear of hypoglycemia(FoH)and quality of life between patients with type 1 diabetes mellitus(T1DM)and type 2 diabetes mellitus(T2DM).Methods A total of 21 patients with T1DM and 269 patients with T2DM in Departments of Endocrinology from three tertiary hospitals in Tianjin from February to August,2019 were investigated by multicenter sampling.Among them,156 cases(53.8%)were males and 134 cases(46.2%)were females,with an average age of(55.12±9.54)years old.All the subjects were surveyed by the questionnaires including the general information questionnaire,the Chinese version of Hypoglycemia Fear SurveyⅡ-Worry Scale(CHFSⅡ-WS),the medical outcomes study item short Form health survey(SF-36),and the World Health Organization Five-item Well-Being Index(WHO-5).Kruskal-Wallis H test or Mann-Whitney U test was used for the measurement data,one-way analysis of variance(ANOVA)was used for comparison between groups.Chi-square test was used for statistical data.Multivariate linear regression was used for multivariate analysis.Results The differences of frequency and type of hypoglycemia between T1DM and T2DM patients were statistically significant(χ^(2)=80.648,P<0.05;χ^(2)=118.856,P<0.05).Scores of CHFSⅡ-WS,WHO-5,physiological function(PF),physical pain(BF),overall health(GH),social function(SF),emotional function(RE),mental health(MH),health change(HT)dimension of SF-36 were significantly different between patients with T1DM and T2DM(all P<0.05).There were significant differences in the scores of PF,SF and HT of CHFSII-WS and SF-36 among the diabetic patients with different types of hypoglycemia(all P<0.05).Multiple linear regression analysis showed that diabetes mellitus type,WHO-5 score,sex,mental health,regular examination and economic status were the independent influencing factors of FoH(partial regression coefficient was-1.621,0.027,0.407,-0.010,0.479,-0.226,all P<0.05).Conclusions The frequency,severity and fear level of FoH in T1DM patients are higher than those in T

关 键 词：糖尿病 1型 糖尿病 2型 低血糖恐惧感 生活质量 

分 类 号：R587.1[医药卫生—内分泌]