农村地区中老年2型糖尿病合并结核分枝杆菌潜伏感染者正念水平对心理健康的影响  

Effect of mindfulness level on mental health of middle-aged and elderly people with type 2 diabetes mellitus comorbidity latent tuberculosis infection in rural areas

作　　者：戴振威 张浩然 荆舒 肖伟军 王浩[1] 黄依漫 陈旭[1] 付佳琪 吴奕锦 高磊[2] 苏小游[1] Dai Zhenwei;Zhang Haoran;Jing Shu;Xiao Weijun;Wang Hao;Huang Yiman;Chen Xu;Fu Jiaqi;Wu Yijin;Gao Lei;Su Xiaoyou(School of Population Medicine and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100005,China;Institute of Pathogen Biology,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院/北京协和医学院群医学及公共卫生学院,北京100005 [2]中国医学科学院/北京协和医学院病原生物学研究所,北京100730

出　　处：《中国防痨杂志》2023年第2期188-194,共7页Chinese Journal of Antituberculosis

基　　金：中国医学科学院医学与健康科技创新工程(2020-I2M-2-015)。

摘　　要：目的:调查农村地区中老年2型糖尿病(type 2 diabetes mellitus,T2DM)合并结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)的现况,探索T2DM合并LTBI者正念水平对抑郁的影响及焦虑的中介效应。方法:采用便利抽样的方法,于2021年11月2—12日,选取河南省中牟县农村地区的469例中老年T2DM患者作为研究对象,进行问卷调查及LTBI检测。调查问卷包括一般资料、五条目正念注意觉知量表、广泛性焦虑障碍量表、患者健康问卷。采用γ-干扰素释放试验(interferon-gamma release assay,IGRA)进行LTBI检测。利用结构方程模型检验正念水平对抑郁的影响及焦虑的中介效应。结果:469例研究对象中IGRA阳性者共74例,占15.78%。74例T2DM合并LTBI者正念注意觉知量表得分为5.00(5.00,10.00),其中,女性的患者健康问卷得分[0.00(0.00,2.00)]和广泛性焦虑障碍量表得分[0.50(0.00,3.00)]高于男性[分别为0.00(0.00,0.00)和0.00(0.00,0.75)];家庭年收入≤20000元者患者健康问卷得分[0.00(0.00,2.25)]高于家庭年收入>20000元者[0.00(0.00,0.00)];近12个月未饮酒者广泛性焦虑障碍量表得分[0.00(0.00,3.00)]高于近12个月饮酒者[0.00(0.00,0.00)];无高血压者患者健康问卷得分[1.00(0.00,4.00)]高于有高血压者[0.00(0.00,0.75],差异均有统计学意义(Z值分别为1.789、2.509、2.572、2.133、2.018,P值均<0.10)。6例T2DM合并LTBI者中存在焦虑症状(8.10%,6/74),4例存在抑郁症状(5.40%,4/74),3例(4.10%,3/74)同时存在焦虑症状和抑郁症状。以正念为自变量,抑郁为因变量,焦虑为中介变量,性别、年收入、近12个月是否饮酒、是否高血压为协变量构建偏最小二乘法结构方程模型。模型具有良好的信度、收敛效度和区分效度。模型中正念对焦虑的影响[β=-0.394(95%CI:-0.778~-0.115),P=0.036)、焦虑对抑郁的影响[β=0.878(95%CI:0.446~0.979),P<0.001]差异有统计学意义;正念对抑郁的中介效应差异有统计学意义[β=Objective:To investigate the prevalence of latent tuberculosis infection(LTBI)in the middle-aged and elderly type 2 diabetes mellitus(T2DM)patients in rural areas of China,and to explore the influence of mindfulness on depression and the mediation effect of anxiety in T2DM comorbidity with LTBI patients.Methods:From November 2 to November 12,2021,using a convenient sampling method,469 middle-aged and elderly patients T2DM in rural areas of Zhongmu County,Henan Province were selected as the research participants for questionnaire survey and LTBI detection.The questionnaire includes general information,Five-item Mindful Awareness Attention Scale,Generalized Anxiety Disorder Questionnaire,and Patient Health Questionnaire.LTBI was detected by interferon-gamma release assay(IGRA).Structural equation modeling was used to test the mediation effect of anxiety between mindfulness and depression.Results:Of the 469 participants,74 were IGRA positive,accounting for 15.78%.The score of Five-item Mindful Awareness Attention Scale in the 74 T2DM participants with LTBI was 5.00(5.00,10.00).The score of Patient Health Questionnaire and Generalized Anxiety Disorder Questionnaire in female were higher than male(0.00(0.00,2.00)vs.0.00(0.00,0.00)and 0.50(0.00,3.00)vs.0.00(0.00,0.75),respectively);the score of Patient Health Questionnaire in those with an annual income of less than RMB 20000 yuan was higher than those with an annual income of more than RMB 20000 yuan(0.00(0.00,2.25)vs.0.00(0.00,0.00));the score of Generalized Anxiety Disorder Questionnaire in those did not drink in the past 12 months was higher than those drank in the past 12 months(0.00(0.00,3.00)vs.0.00(0.00,0.00));the score of Patient Health Questionnaire in those without hypertension was higher than those with hypertension(1.00(0.00,4.00)vs.0.00(0.00,0.75),all the differences were statistically significant(Z values were 1.789,2.509,2.572,2.133,and 2.018,respectively,all P<0.10).The prevalence of anxiety and depression in T2DM patients with LTBI were 8.10%(6/74)and

关 键 词：中年人(45~64) 糖尿病 2型 分枝杆菌 结核 共病现象 心理学 医学 

分 类 号：R587.1[医药卫生—内分泌] R52[医药卫生—内科学] R395[医药卫生—临床医学]