胰岛素治疗对2型糖尿病患者抑郁情绪的影响研究

Impact of Insulin on the Depression in Type 2 Diabetes Mellitus Patients

目的探讨胰岛素治疗对2型糖尿病(T2DM)患者抑郁情绪的影响。方法本研究为横断面研究,采用简单随机抽样的方法,连续选取2014年1月—2015年6月在四川省遂宁市中医医院内分泌科门诊及住院病房就诊的240例T2DM患者,按照治疗方案分为胰岛素组与口服药物组,每组各120例。采用流调用抑郁自评量表(CESD)对患者的抑郁情绪进行现况调查,并采用多因素Logistic回归模型分析胰岛素治疗对患者抑郁情绪的影响。结果胰岛素组患者较口服药物组年龄增大、糖尿病病程延长、并发症数量增多,伴发高血压比例增多(P<0.05)。胰岛素组患者抑郁评分高于口服药物组[(23.9±6.7)分与(21.1±6.1)分](P<0.05)。胰岛素组患者抑郁检出率高于口服药物组[35.0%(42/120)与20.0%(24/120)](P<0.05)。多因素Logistic回归分析结果发现:校正混杂因素后,以口服药物组作为参照,胰岛素组对抑郁情绪影响的OR值为3.374[95%CI(2.319,6.535),P<0.001]。结论抑郁情绪在T2DM患者中普遍存在,胰岛素治疗对T2DM患者抑郁情绪的发生存在影响,对此类患者应当加强心理干预。

Objective To investigate the impact of insulin on the depression in type 2 diabetes mellitus（ T2DM）patients. Methods This study was a cross-sectional survey. Used simple random sampling method,continuous selected 240 cases of T2 DM patients in outpatient and inpatient wards of Department of Endocrinology in Suining Municipal Hospital of TCM,Sichuan Province from January 2014 to June 2015,T2 DM patients were divided into two groups according to treatment regimen,insulin group and oral anti-diabetic drugs group,each group of 120 cases. Center for Epidemiological Survey,Depression Scale（ CES-D） was used to investigate the depression status of patients. Multiple Logistic regression analysis was used to analyze the influencing factors of the depression in patients with T2 DM. Results Insulin group was higher in age,longer course of diabetes,more complications and higher proportion of hypertension than that in anti-diabetic drugs group（ P 〈 0. 05）. Score of depression in insulin group was significantly higher than that in oral anti-diabetic drugs group [（ 23. 9 ± 6. 7） vs.（ 21. 1 ±6. 1） ]（ P 〈 0. 05）. Detection rate of depression in insulin group was significantly higher than that in oral anti-diabetic drugs group [35. 0%（ 42/120） vs. 20. 0%（ 24/120） ]（ P 〈 0. 05）. The result of multivariate Logistic regression analysis showed that,after correcting for confounding factors,treated with oral anti-diabetic drugs group as a reference,the OR of insulin group on depression was 3. 374[95% CI（ 2. 319,6. 535）,P 〈 0. 001]. Conclusion Depression is common in T2 DM patients,the presence of insulin therapy on the incidence of T2 DM patients with depression,we should strengthen psychological intervention for these patients.