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目的探讨抑郁症状对老年糖尿病肾病(DN)患者的血糖控制及生活质量的影响。方法对106例DN患者采用抑郁自评量表(SDS)、糖尿病生活质量特异性量表(DSQL)和自行设计的一般情况问卷调查,了解DN患者抑郁发生情况,并分析抑郁对血糖控制及生活质量的影响。结果老年DN患者伴发抑郁症状的检出率为50.94%;抑郁组DN患者Hb Alc(t=5.34,P=0.025)、FBG(t=3.48,P=0.037)、2h PG(t=4.86,P=0.030)及DSQL总分(t=4.92,P=0.027)均较非抑郁组明显升高;FBG在DN患者的文化程度(F=5.87,P=0.023)、家族史(t=3.04,P<0.049)的分布上存在显著性差异,而DSQL在DN患者的年龄(t=3.27,P=0.039)、DN病程(t=4.49,P=0.017)及伴随疾病(t=3.15,P=0.048)的分布上存在显著性差异;多元线性回归分析显示,SDS评分均是老年DN患者血糖控制(t=3.33,P<0.042)及生活质量(t=2.98,P=0.014)的独立危险因素。结论老年DN患者存在明显抑郁负性情绪,整体生活质量水平较低,且抑郁与血糖控制及生活质量密切相关。
Objective To investigate the effect of depressive symptoms on blood glucose control and quality of life in elderly patients with diabetic nephropathy (DN). Methods A total of 106 cases of DN patients with depression self-rating scale (SDS), diabetes quality of life scale (DSQL) and self-designed general situation questionnaire to understand the incidence of depression in patients with DN, and analysis of depression on blood glucose control and life Quality impact. Results The detection rate of depression associated with DN was 50.94% in elderly patients with DN. The Hb Alc (t = 5.34, P = 0.025), FBG (t = 3.48, (P = 0.030) and DSQL score (t = 4.92, P = 0.027) were significantly higher than those in non-depression group. There was significant difference in FBG among DN patients with F (5.87, P = 0.023) There was a significant difference in the distribution of DSQL among patients with DN (t = 3.27, P = 0.039), DN duration (t = 4.49, P = 0.017) and concomitant disease (t = 3.15, P = 0.048). Multivariate linear regression analysis showed that SDS scores were independent risk factors of glycemic control (t = 3.33, P <0.042) and quality of life (t = 2.98, P = 0.014) . Conclusion The elderly patients with DN have significant depression and negative emotions, the overall quality of life is low, and depression is closely related to blood sugar control and quality of life.