老年综合评估干预对老年2型糖尿病合并情绪障碍患者的影响

Effects of comprehensive geriatric assessment and intervention on treatment outcomes of elderly patients with type 2 diabetes mellitus and emotional disorders

目的探讨老年综合评估(CGA)干预对老年2型糖尿病合并情绪障碍患者的影响。方法选取2020年3月至2021年3月郑州大学第一附属医院老年内分泌科收治的108例2型糖尿病合并情绪障碍的老年患者,随机分为常规治疗组和CGA组(各54例),CGA组在常规治疗组基础上进行CGA干预。进行8周的临床观察后,并综合评估患者的认知状态、营养状况及跌倒等指标的变化。结果治疗前和治疗8周后,常规治疗组和CGA组患者的FPG水平:[常规治疗组(10.16±0.90)mmol/L、(8.70±2.98)mmol/L,t=2.58,P=0.011;CGA组(9.94±0.82)mmol/L、(7.12±2.25)mmol/L,t=8.65,P=0.000]、2 hPG水平[常规治疗组(11.83±3.92)mmol/L、10.53±2.70)mmol/L,t=2.01,P=0.047;CGA组(10.64±2.99)mmol/L、(9.26±1.89)mmol/L,t=2.87,P=0.005]、HbA1C(%)[常规治疗组:(9.76±1.09、8.66±2.64)%,t=2.83,P=0.006;CGA组(9.38±2.92)%、(7.81±1.78)%,t=3.37,P=0.001]、HAMD-24评分[常规治疗组(25.69±4.70)分、(24.20±2.48)分,t=2.06,P=0.042;CGA组(24.03±4.00)分、(22.11±1.38)分,t=3.33,P=0.001]、HAMD-14评分[常规治疗组(19.66±2.84、18.41±2.34)分,t=2.50,P=0.014;CGA组(18.77±2.48)分、(17.39±2.36)分,t=2.96,P=0.004]均低于治疗前,CGA组较常规治疗组的变化更显著(均P<0.05)。结论老年2型糖尿病合并情绪障碍患者早期进行CGA干预,能够更加显著改善患者的血糖水平和情绪障碍。

Objective To investigate the effects of comprehensive geriatric assessment(CGA)and intervention on treatment outcomes of type 2 diabetes and concurrent emotional disorders in the elderly.Methods 108 type 2 diabetes cases with emotional disorders were enrolled from March 2020 to March 2021 in the First Affiliated Hospital of Zhengzhou University and randomly divided into the conventional treatment group and the CGA group(54 cases each).The control group was given standard drug treatment and psychological counseling,whereas the CGA group was additionally given individualized treatment based on CGA guidelines.After observation for 8 weeks,clinical effects in the two groups were examined.Changes in cognitive status,nutritional status,fall risk and results on other indicators in patients were comprehensively assessed and statistically analyzed.Results Compared with pre-treatment data,8 weeks of treatment for both the control group and the CGA group resulted in decreased FPG levels[control group(10.16±0.90)mmol/L,(8.70±2.98)mmol/L,t=2.58,P=0.011;CGA group:(9.94±0.82)mmol/L,(7.12±2.25)mmol/L,t=8.65,P=0.000],2hPG levels[control group:(11.83±3.92)mmol/L,(10.53±2.70)mmol/L,t=2.01,P=0.047;CGA group:(10.64±2.99)mmol/L,(9.26±1.89)mmol/L,t=2.87,P=0.005],HbA1C(%)[control group:(9.76±1.09)%,(8.66±2.64)%,t=2.83,P=0.006;CGA group:(9.38±2.92)%,(7.81±1.78)%,t=3.37,P=0.001],HAMD-24 scores[control group(25.69±4.70),(24.20±2.48),t=2.06,P=0.042;CGA group(24.03±4.00),(22.11±1.38),t=3.33,P=0.001],and HAMD-14 scores[control group(19.66±2.84),(18.41±2.34),t=2.50,P=0.014;CGA group(18.77±2.48),(17.39±2.36),t=2.96,P=0.004],respectively,with more marked changes in all measures in the CGA group than in the control group(all P<0.05).Conclusions Early CGA can effectively improve blood glucose levels and relieve mood disorders in elderly type 2 diabetes with emotional disorders.