降糖药物治疗2型糖尿病伴抑郁患者的效果观察  

Clinical effects of hypoglycemic drugs in patients with type 2 diabetes mellitus and depression

作　　者：袁昊 钟楚毓 吴琼 王力 王倩倩 冯烈[5] YUAN Hao;ZHONG Chuyu;WU Qiong(Department of Endocrinology and Metabolism,The Third People's Hospital of Zhuhai,Zhuhai 519000,China)

机构地区：[1]珠海市第三人民医院内分泌代谢科,519000 [2]暨南大学附属珠海医院肾内科 [3]暨南大学附属珠海医院内分泌代谢科 [4]珠海市第三人民医院精神科 [5]暨南大学附属第一医院内分泌代谢科

出　　处：《中国糖尿病杂志》2024年第3期192-196,共5页Chinese Journal of Diabetes

基　　金：广东省珠海市医学科研项目(2220009000003)。

摘　　要：目的探讨降糖药物对降低T2DM患者抑郁程度的影响。方法选取2022年1~12月于珠海市第三人民医院和暨南大学附属珠海医院门诊新诊断T2DM或近3个月未使用降糖药物的T2DM伴轻中度抑郁患者160例,HbA1c 7%~9%,随机分为二甲双胍治疗组(Met)、Met联合磺脲类治疗组(Met+SUs)、Met联合DPP-4i治疗组(Met+DPP-4i)、Met联合GLP-1受体激动剂治疗组(Met+GLP-1RA),每组各40例。比较各组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分。结果Met+DPP-4i、Met+GLP-1RA组治疗后,HAMD、HAMA分值降低(P<0.05),HAMD中度抑郁及HAMA明显焦虑比例降低(P<0.05)。Pearson相关分析显示,HAMD评分差值、HAMA评分差值与Met+GLP-1RA组HbA1c差值呈正相关(P<0.05)。结论Met联合DPP-4i、GLP-1RA可改善T2DM伴抑郁患者的抑郁程度。Objective To explore the clinical effects of hypoglycemic drugs on depression degree in patients with type 2 diabetes mellitus(T2DM).Methods A total of 160 newly diagnosed T2DM patients or T2DM patients who have not used hypoglycemic drugs in the past 3 months with mild to moderate depressive episodes and visited our outpatient department were enrolled in this study from January to December2022.All the participants HbA_1c were ranged from 7%to 9%.They were randomly divided into four groups:Metformin treatment group(Met,n=40),Met combined with sulfonylurea treatment group(Met+SUs,n=40),Met combined with DPP-4i treatment group(Met+DPP-4i,n=40),and Met combined with GLP-1 receptor agonist treatment group(Met+GLP-1RA,n=40).All the patients were scored with the Hamilton Depression Rating Scale(HAMD)and the Hamilton Anxiety Rating Scale(HAMA)in each group.Results The Met+DPP-4i and Met+GLP-1RA groups showed the most significant decrease in HAMD and HAMA scores after treatment(P<0.05),while the proportion of moderate depression and significant anxiety in HAMD decreased(P<0.05).Pearson correlation analysis showed that-HAMD,-HAMA were positively correlated with-HbA_1c in the Met+GLP-1RA group(P<0.05).Conclusion The combination of Met with DPP-4i and GLP-1RA has the most significant effect on improving the degree of depression in patients with T2DM and depression.

关 键 词：糖尿病 2型 降糖药物 抑郁程度 

分 类 号：R587.1[医药卫生—内分泌] R749.4[医药卫生—内科学]