【摘要】 目的探讨2型糖尿病合并抑郁症的相关危险因素及其与动脉硬化关系。方法收集184例2型糖尿病住院患者作为研究对象,入选对象均行HAMD-17量表测评,其中106例2型糖尿病合并抑郁症患者(符合CCMD-3抑郁症诊断标准,HAMD-17≥17分)为病例组,78例2型糖尿病未合并抑郁症患者(HAMD-17≤7分)为对照组;入选对象均行糖化血红蛋白(HbA1c)、血脂、C-反应蛋白(CRP)、颈动脉内膜中层厚度(IMT)等检测。分析2型糖尿病合并抑郁症的相关危险因素,及其与炎症、动脉硬化关系。结果 (1)2型糖尿病合并抑郁症组BMI较大、腹围较大、糖尿病微血管并发症发病率较对照组高、女性患者较多,治疗方式存在差异(P<0.05);2组年龄、糖尿病病程比较,差别无统计学意义(P>0.05);(2)2型糖尿病合并抑郁症组IMT、CRP、HbA1c明显高于对照组,差别具有统计学意义(P<0.05);2组血脂比较,差别无统计学意义(P>0.05);(3)多元线性回归分析结果显示:HAMD评分与IMT呈正相关,标准回归系数为0.234,P<0.05,与HbA1c呈正相关,标准回归系数为0.348,P<0.01,相关性均有统计学意义,HAMD评分与CRP无相关性,标准回归系数为0.030,P>0.05。结论 2型糖尿病患者中女性、肥胖、血糖控制不佳、微血管并发症、使用胰岛素治疗等都是与2型糖尿病合并抑郁症的相关因素;炎症、动脉硬化与抑郁症的发病过程有关,2型糖尿病合并抑郁症与糖尿病大血管病变和微血管病变均有相关。更多还原

【Abstract】 Objective To investigate the risk factors of type 2 diabetes with depression and its relationship with atherosclerosis.Methods The HAMD-17 measuring scale was determined in 184 inpatients with type 2 diabetes from Fujian Provincial Hospital.A total of 106patients with type 2 diabetes with depression were set as the case group(according with the depression of CCMD-3diagnostic criteria,HAMD-17≥17points),and 78patients with type 2 diabetes without depression were set as the control group(HAMD-17≤7).Glycosylated hemoglobin,lipids,C-reactive protein(CRP),and carotid intimamedia thickness(IMT)were performed in all patients.The risk factors associated with type 2 diabetes with depression,and its relationship with inflammation and atherosclerosis was analyzed.Results(1)A higher BMI,abdominal circumference,incidence of diabetes microvascular complications and more female patients were found in type 2 diabetes with depression group.There are significant differences in treatment method between the two groups(P<0.05),but no statistically significant differences in age and duration of diabetes between the two(P>0.05).(2)The levels of IMT,CRP,HbA1cin the case group were significantly higher than those in the control group(P<0.05),while there were no statistically significant differences in lipids between the two groups(P>0.05).(3)In multiple linear regression analysis,the HAMD scores were positively correlated with IMT(Standard regression coefficient=0.234,P<0.05)and also positively correlated with HbA1c (Standard regression coefficient=0.348,P<0.01),but no correlation was observed between HAMD scores and CRP(Standard regression coefficient=0.030,P>0.05).Conclusions Female,obesity,poor glycemic control,microvascular complications and insulin therapy might all be the risk factors of type 2 diabetes with depression.Inflammation and atherosclerosis are related with the pathogenesis of depression in type 2 diabetes.Type 2 diabetes with depression is associated with both diabetic vascular disease and microvascular disease.更多还原