2型糖尿病患者的糖化血红蛋白水平、胰岛素抵抗指数及并发症与心理控制源的相关性研究

Study of the correlation between glycosylated hemoglobin level,insulin resistance index,complications and psychological control sources in type 2 diabetes patients

目的 探究2型糖尿病(diabetes mellitus type 2,T2DM)患者的糖化血红蛋白(HbA1c)水平、胰岛素抵抗指数(HOMA-IR)及并发症与心理控制源的相关性。方法 选取漯河市中心医院收治的130例T2DM患者为研究对象,分别检测患者的HbA1c水平,根据空腹血糖和空腹胰岛素计算HOMA-IR,评估并发症种类,并采用多维度健康心理控制源量表(Multidimensional Health Locus of Control Scale,MHLC)调查患者的心理控制源状态。对比分析不同HbA1c水平、HOMA-IR水平及伴不同并发症T2DM患者的MHLC量表评分。结果 T2DM患者内控性量表(Internality Health Locus of Control Scale,IHLC)评分低于常模(P <0.05),而健康权威控制量表(Powerful Others Health Locus of Control Scale,PHLC)、机遇量表(Chance Health Locus of Control Scale,CHLC)评分均高于常模(P <0.05)。IHLC评分随HbA1c、HOMA-IR的升高而显著降低(P <0.05),随患者并发症种类的增加而显著降低(P <0.05);PHLC、CHLC评分随HbA1c、HOMA-IR的升高而显著升高(P <0.05),随患者合并并发症种类的增加而显著升高(P <0.05)。结论 对于T2DM患者,伴随HbA1c水平升高、HOMA-IR指数的增加及并发症种类的增多,其对疾病的内控管理能力下降,更倾向于外部健康权威和机遇。临床上可通过对T2DM患者HbA1c、HOMA-IR水平的调控及并发症的预防干预,促进患者建立健康的心理行为,避免不良社会心理因素影响病情进展。

Objective To investigate the correlation between glycosylated hemoglobin(HbA1c)level,insulin resistance index(HOMA-IR),complications and psychological control sources in patients with type 2 diabetes mellitus(T2DM).Methods 130 patients with T2DM from Luohe Central Hospital were selected as subjects,HbA1c levels of patients were detected,fasting blood glucose and fasting insulin were used to calculate HOMA-IR,complications were evaluated,and Multidimensional Health Locus of Control Scale(MHLC)was used to investigate patients’state of psychological locus of control.The MHLC scale scores of patients with different HbA1c levels,different HOMA-IR levels and different complications were compared and analyzed.Results Internality Health Locus of Control Scale(IHLC)score of T2DM patients was lower than the norm(P<0.05),but Powerful Others Health Locus of Control Scale(PHLC)score and Chance Health Locus of Control Scale(CHLC)score were higher than the norm(P<0.05).IHLC Scale scores were significantly decreased with the increase of HbA1c,HOMA-IR and complications(P<0.05).PHLC scale and CHLC scale scores were significantly increased with the increase of Hb A1c,HOMA-IR and complications(P<0.05).Conclusion With the increase of HbA1c,HOMA-IR levels and the complications in T2DM patients,their internal control and management ability of the disease decrease,and they are more inclined to external health authorities and opportunities.Clinically,the regulation of HbA1c and HOMA-IR levels in T2DM patients and the prevention and intervention of complications can promote the establishment of healthy psychological behaviors in patients and prevent the progression of disease caused by adverse social psychological factors.