焦虑与2型糖尿病患者生活质量的关系

Relationship between anxiety and quality of life in patients with type 2 diabetes mellitus

目的探索焦虑与2型糖尿病（T2DM）患者生活质量的关系，为有针对性地开展社区干预及提高患者生活质量提供依据。方法采用多阶段整群随机抽样方法，于2012年11月至2013年1月抽取徐州市4个县（市）区，在每个县（市）区内随机抽取8—10个村／小区，每村／小区内确诊的T2DM患者均为研究对象。使用自行设计的问卷、匹兹堡睡眠质量指数量表（PSQI）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、糖尿病患者生活质量特异性量表（DSQL）进行面对面调查。将受试者按焦虑程度分为轻、中、重度组，比较各组焦虑与生活质量的关系差异。采用方差分析对多组间的均数进行比较，应用多元线性回归和Pearsonx。检验分析焦虑与生活质量的关系。结果共调查776例糖尿病患者，58．89％（457／776）的患者有不同程度的焦虑，无、轻、中、重度焦虑患者的比例依次为41．11％（319/776）、49．61％（385／776）、7．99％（62／776）、1．29％（10／776），生活质量总分依次为（40±9）、（47±11）、（52±15）和（65±13）分，差异有统计学意义（F=43．589，P〈0．05）。经相关分析显示，除社会关系维度（r=0．046，P〉0．05）以外，焦虑与患者DSQL总分、生理功能维度、心理精神维度、治疗维度均呈正相关（r=0．395、0．454、0．341、0．150，均P〈0．05），其中焦虑与生活质量的生理维度相关性最强。校正年龄、性别、文化程度、婚姻、家庭收入、病程、并发症、血糖控制、睡眠质量、抑郁等因素后，焦虑与生活质量的回归系数为0．239，在众多因素中位居第一位。结论与其他因素比较，焦虑严重降低了糖尿病患者的生活质量。

Objective To explore the relationship between anxiety and the quality of life in patients with type 2 diabetes mellitus （T2DM） to perform specific community prevention, and to provide reference to improve the quality of life in patients T2DM. Methods Total of 776 participants who lived in 32 villages / communities of Xuzhou were enrolled with the multistage cluster random sampling method, and were investigated with a self-designed questionnaire, the Pittsburgh sleep quality index （PSQ1）, self rating Anxiety Scale （SAS）, self rating Depression Scale （SDS） and the amount of specific quality of life in patients with diabetes mellitus （DSQL）. The patients were divided into mild, moderate and severe anxiety groups. One-way analysis were used to analyze differences among several groups, Multiple linear regression and Pearson X 2 were used to analyze the association between anxiety and quality of life. Results Of the 776 enrolled diabetes mellitus patients, the prevalent rate of anxiety was 58.89% （457/776）, the percentage of none, mild, moderate and severe anxiety were 41.11%（319/776）, 49.61%（385/776）, 7.99%（62/776）, 1.29% （10/776）respectively. The scores of qualities of life in patients with type 2 diabetes with none, mild, moderate and severe anxiety were （40 ± 9）, （47 ± 11）, （52 ±15） and （65 ± 13）. There were significant differences between different groups （F=43.589, P〈0.05）. The correlation analysis between anxiety and total DSQL scale and components of DSQL showed that except for the social relationship dimension of DSQL（r=0.046, P 〉 0.05）, there were positive correlation between anxiety and total DSQL scale and the other dimensions of DSQL. The correlation between anxiety and total score of DSQL, physiological function dimension, psychological dimension and treatment dimension were 0.395, 0.454, 0.341, 0.150 （P〈0.05, all above）.The results showed that the correlation between anxiety and physical dimensions of DSQL was the strongest. After adjust for age, sex, culture degree, marriage, family income, course of disease, complication, blood glucose control, sleep quality, depression and so on, the regression coefficient of anxiety and quality of life was 0.239, ranked at the first factor in numerous oners. Conclusion Compared with other potential risk factors, the anxiety is the highest negatively related to the quality of life of patients with type 2 diabetes mellitus.