治疗方案对2型糖尿病患者抑郁情绪影响的调查研究

The impact of therapeutic regimen on the depression in type 2 diabetes mellitus： A cross-sectional study

探讨胰岛素与口服降糖药物治疗对2型糖尿病患者抑郁情绪的影响。随机抽取江苏省中医院内分泌科门诊及住院的2型糖尿病患者283例，使用自行设计的问卷和Zung抑郁自评量表（SDS）开展横断面调查。利用t检验或χ2 比较不同治疗方案组患者的基本情况。应用logistic回归分析治疗方案与抑郁情绪的关系。结果显示43.1%的2型糖尿病患者存在不同程度的抑郁症状。与口服药物组相比，胰岛素组存在抑郁的比例更高（胰岛素组53.5%，口服药物组30.5%[P〈0.01），SDS得分更高[胰岛素组（51.7±12.4）分，口服药物组（44.8±10.6）分[P〈0.01]。通过校正年龄、性别、体重指数、糖尿病病程、并发症及HbA1C等多因素后，胰岛素组抑郁发生率仍高于口服药物组（OR=4.218，95% CI 1.764~13.285, P=0.004）。 胰岛素治疗是2型糖尿病患者抑郁发生的独立危险因素，有必要对此类患者加强心理支持。

To explore the depression in type 2 diabetic patients treated with insulin and compared to those treated with oral anti-diabetic drugs. 283 type 2 diabetics were seclected randomly from outpatient and inpatient departments of endocrionology in Jiangsu Province Hospital of Traditional Chinese Medicine, with the self-designed questionnaire and Zung self-rating depression scale to conduct the survey. Comparisons between the two groups were carried out with t-test or x2test for quantitative and qualitative data, respectively. Logistic regression were used for the analysis of the relationship between the therapeutic regimen and depression. Overall, 43.1% of the type 2 diabetic subjects showed depressive symptoms in different degrees. Compared to the oral drug group, the insulin group showed a significantly higher prevalence of depressive symptoms （ insulin group, 53.5% , oral drug group, 30.5% ; P〈0. 01 ） and higher self-rating depression scale scores （ insulin group, 51.7 ± 12.4, oral drug group, 44.8 ± 10.6; P〈 0. 01 ）. Moreover, after an adjustment for age, sex, body mass index, diabetic duration, complications, HbAlcand so on, the insulin group showed a significantly higher frequency of depression （ OR = 4.218, 95 % CI 1. 764-13. 285, P = 0. 004） , compared to the oral drug group. The data showed that insulin treatment is an independent risk factor to the presence of depressive symptoms in type 2 diabetics, and it is necessary to pay more attention to their psychological support.