综合性护理干预对绝经后2型糖尿病患者骨密度和血生化指标的影响

Effects of comprehensive nursing intervention on bone mineral density and the blood biochemical indexes in patients with postmenopausal type 2 diabetes mellitus

目的探讨综合性护理干预对绝经后2型糖尿病患者骨密度与有关血生化指标的影响。方法对健康居民组(46例健康居民)、常规护理组(46例绝经后2型糖尿病患者,开展常规护理)、护理干预组(46例绝经后2型糖尿病患者,开展针对性护理干预)对象进行研究,比较3组对象干预前后胶骨颈骨密度、空腹血糖、血清骨转换生化标记物[Cathek、人Ⅰ型前胶原氨基端原肽(PⅠNP)、β胶原降解产物(β-crosslaps、骨钙素(OT))]和骨特异性碱性磷酸酶(B-ALP)含量差异。结果入院初,常规护理组和护理干预组空腹血糖明显高于健康居民组(P<0.05);干预后常规护理组和护理干预组空腹血糖值明显下降,而股骨颈骨密度明显上升,出院12个月时,常规护理组和护理干预组差异有统计学意义(P<0.05)。所有对象Cathe K、PⅠNP、Β-crosslaps、OT与股骨颈骨密度均呈负相关(P<0.05)。出院12个月时,3组Cathe K、PⅠNP、Β-crosslaps、OT差异有统计学意义,护理干预组Cathe K、PⅠNP、Β-crosslaps、OT明显高于常规护理组,B-ALP低于常规护理组,差异均有统计学意义(P<0.05)。结论综合性护理干预有助于改善绝经后2型糖尿病患者的骨质疏松情况及其他并发症的发生,骨密度及骨转换生化指标联合检测有利于骨质疏松症患者的预防、治疗和疗效观察。

Objective To observe the effects of comprehensive nursing intervention on bone mineral density and related blood biochemical indexes in patients with postmenopausal type 2 diabetes mellitus. Methods A total of 46 healthy residents were enrolled as healthy resident group,and 46 patients with postmenopausal type 2 diabetes mellitus were enrolled as routine nursing group,who were given routine nursing,moreover,the other 46 patients with postmenopausal type 2 diabetes mellitus were enroled as nursing intervention group,who were given targeted nursing intervention.The differences of bone mineral density,fasting blood glucose, Cathek,P Ⅰ NP,β-crosslaps,OT and B-ALP before and after the intervention Were observed and compared among the three groups. Results On admission,the levels of fasting glucose in routine nursing group and nursing intervention group were significantly higher than those in healthy resident group ( P <0.05). After the intervention,the levels of fasting blood glucose in routine nursing group and nursing intervention group were significantly decreased,however, the femoral neck bone density was increased significantly.At 12 months after discharging from hospital,there were significant differences between routine nursing group and nursing intervention group ( P <0.05).Moreover the levels of Cathe K,P Ⅰ NP,Β-crosslaps,OT were negatively correlated with femoral neck bone mineral density in the three grousp ( P <0.05).At 12 months after discharging from hospital,there were significant differen ces in the levels of bone mineral density indicators including Cathe K,P Ⅰ NP,β-crosslaps,OT among the three groups,moreover, the levels of Cathe K,P Ⅰ NP,Β-crosslaps,OT in nursing intervention group were obviously higher than those in routine nursing group,but the levels of B-ALP were significantly lower than those in routine nursing group ( P <0.05). Conclusion Comprehensive nursing intervention is helpful to improve the osteoporosis status and the occurrence of the other complications in patients with postmenopausal type 2 diabetes mellitus,moreover,the combination detection of bone mineral density and bone biochemical indexes is beneficial for the prevention,treatment and curative effect observation.