老年2型糖尿病患者结肠功能紊乱相关因素的研究

Causative Factors for Colonic Function Disorder in Elderly Type 2 Diabetic Patients

为观察老年2型糖尿病合并结肠功能紊乱患者的临床特点，并探讨发病相关因素，将46例老年2型糖尿病合并结肠功能紊乱患者作为观察组，40例无结肠功能紊乱症状的老年2型糖尿病患者作为对照组，观察两组患者基本情况、医院焦虑抑郁量表（HADS）评分及血糖水平，应用Logistic回归模型进行多因素分析。结果显示，（1）观察组患者病程显著长于对照组[（7．6±4．1）年vs（2．8±1．3）年，P〈0．053，而烟酒嗜好、居住地、体质指数（BMI）、受教育水平均无统计学意义（P〉0．05）；（2）观察组HADS总评分[（10．8±2．0）分vs（5．5±1．1）分]及HADS评分〉8分者（52．5％vs7．5％）比例均高于对照组（P〈0．001）；（3）观察组患者糖化血红蛋白、空腹血糖及餐后血糖水平较对照组均无统计学意义（P〉0.05），但血糖波动水平显著高于对照组[（4．17±1．20）vs（2．63±0．87）mmol／L，P〈0．051；（4）Logistic回归分析显示，糖尿病病程（OR=14．576）、血糖波动水平（0R=7．514）及HADS评分（0R=11．924）与糖尿病患者发生结肠功能紊乱关系具有显著性差异（P〈0．05）。结果表明，糖尿病病程长、血糖水平波动大及有焦虑／抑郁障碍的老年2型糖尿病患者最可能发生结肠功能紊乱。

This study was to observe the clinical features ot7 elderly type 2 diabetic patients with colonic function disorder and to explore its causative factors. Forty-six cases of type 2 diabetes（D） with colonic function disorder were selected as the observation group and 40 cases without colonic function disorder as the control group. Both groups were observed for general condition, HADS（Hamihon depression scales） score and blood glucose level,for which Logistic regression model was used for multivariate analysis. The results showed that 1） observation group ran a significantly longer disease course than control groupF（7.6±4.1）yr. vs （2.8±1.3）yr. , P 〈0.05],but no significant difference was found in cigarette and alcohol addiction,place of residence, body mass index （BMI） and educational level（ P〉0. 05）;2） observation group had a higher HADS score [（10.8±2.0） vs （5.5±1. 1）points]and a higher proportion of HADS score above 8 points （52.5% vs 7.5%）than control group（ P 〈0. 001）;3） glycated hemoglobin,fasting plasma glucose and postprandial blood glucose levels in observation group showed no significant difference from those in control group（ P 〉0.05）, but blood glucose levels fluctuated obviously [（4.17±1.20） vs （2.63±0.87）mmol/L, P 〈0.05];4）Logistic regression analysis showed that diabetic course （OR=14. 576） ,blood fluctuation（OR=7. 514） and HADS score （OR=11. 924） were significantly different from the occurrence of functional disorder of colon in diabetes（ P 〈0.05）. It is concluded that elderly patients who run a long course of type 2 D and have fluctuating blood glucose levels and who have anxiety or depression are at the highest risk for type 2 D colonic function disorder.