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2型糖尿病患者抑郁情绪与糖、脂代谢及其应对方式的分析
其他题名To analyse the relationship between depression, glycated hemoglobin,lipid metabolism and coping style in patients with type 2 diabetes mellitus
牛徐林
学位类型同等学力硕士
导师张建新
2012
学位授予单位中国科学院研究生院
学位授予地点北京
学位专业心理学
关键词2型糖尿病 抑郁 血糖 血脂 应对方式
摘要 
糖尿病已成为发达国家中继心血管病和肿瘤之后的第三大非传染性疾病,随着物质生活水平的提高,人均寿命的延长以及生活节奏的加快,糖尿病发病率还在以惊人的速度增长,给社会和经济带来沉重负担,是严重威胁人类健康的世界性公共卫生问题。我国糖尿病发病率居世界第2位。糖尿病是由多种原因引起的、以慢性血葡萄糖水平升高为特征的代谢性疾病。由于胰岛素分泌或/和作用缺陷(胰岛素抵抗),引起碳水化合物、蛋白质、脂肪等代谢异常。生物-心理-社会医学模式使临床的医护人员从原来的只关注病人的躯体疾患,也更加关注患者的的心理、社会因素对疾病造成的影响,研究表明:2型糖尿病患者抑郁高发,但引起的原因不是很清楚。因此,本课题针对2型糖尿病患者的抑郁、焦虑情绪与其糖脂代谢和应对方式进行分析,探讨引起2型糖尿病患者抑郁的原因,为临床2型糖尿病管理提供依据。本课题拟要探讨的主要问题如下:  1.调查2型糖尿病(T2DM)患者抑郁及焦虑状况。 2.探讨T2DM患者抑郁情绪与糖化血红蛋白、血脂的关系。 3.探讨T2DM患者抑郁情绪与其应对方式的关系。 本课题选择临床已确诊2型糖尿病患者76例、非糖尿病疾病组37例和健康对照组38例,分别使用Zung氏抑郁自评量表评定,用焦虑自评量表进行验证考察。三组分别测定糖化血红蛋白(HbA1-c)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。同时进行医学应对问卷(MCMQ)评定。通过对数据的卡方检验、方差分析和相关分析得出如下结果: 1. T2DM组与非糖尿病疾病组抑郁、焦虑患病率较高,是健康对照组的4-5倍。2. T2DM组与非糖尿病疾病组的HbA1-c显著高于健康对照组,T2DM组的HbA1-c显著高于非糖尿病疾病组。3. T2DM组与非糖尿病疾病组的TG显著高于健康对照组;T2DM组的TC显著低于对照组;T2DM组的HDL-c显著低于非糖尿病疾病组和对照组,非糖尿病疾病组的HDL-c也显著低于对照组;非糖尿病疾病组的LDL-c显著高于健康对照组。4.三组整体的抑郁情绪与年龄、焦虑、TG、屈服呈正相关,与HDL-c呈负相关,健康对照组的抑郁情绪与年龄、焦虑、HbA1-c、TG呈正相关,与面对呈负相关;T2DM组的抑郁情绪与年龄、焦虑、屈服呈正相关,非糖尿病疾病组的抑郁情绪与焦虑、屈服呈正相关。中介和调节效应分析,高密度胆固醇负向预测个体的抑郁水平,但不同的疾病分组中介了这一结果,但控制年龄后,这一关系不显著。糖尿病组高回避应对的人焦虑程度明显高于低回避应对的人,采用高屈服应对方式会更显著影响其抑郁程度。故得出以下结论: 1.T2DM患者中焦虑、抑郁情绪与健康人群比较发病率较高,抑郁情绪在其它疾病住院病人中也广泛存在。2.在对T2DM患者加强疾病宣教、监控血糖、血脂防止并发症发生的同时,应加强对使用回避、屈服应对方式的糖尿病患者做好焦虑、抑郁情绪的筛查工作,并对患者出现的负性情绪及时开展心理疏导工作,让病人用积极乐观的方式面对疾病,提高患者的生活质量。图3个,表12个,参考文献48篇。
其他摘要Diabetes has become the third non- infectious disease ranking after cardiovascular disease and cancer in a developed country .with the rising of material living standard, the prolong of people average life and the speeding up of life rhythm, the diabetes is still growing with amazing speed , brings heavy burden to society and economy, and is a serious threat to human health and a worldwide public health problem. Our country in the world diabetes incidence ranks the second. Diabetes is caused by a variety of reasons, and chronic blood glucose levels rise is the characteristic of metabolic disease. Insulin secretion or/and function defects (insulin resistance), cause carbohydrate, protein, fat and other metabolic abnormalities. The biological-psychology-society medical model made clinical medical staff focus not only on the patient's body disease, but also pay more attention to the patients of the psychological and social factors on the impact of the disease. The study showed that patients with type 2 diabetes were easily suffered from depression, but the cause is not very clear. Therefore, the subject is the analysis of depression and anxiety, fat metabolism and sugar way to deal with in patients with type 2 diabetes, and this paper discusses the depression cause of patients with type 2 diabetes, provides the basis for the management of clinical type 2 diabetes. This paper tried to answer questions as follow: 1. To survey type 2 diabetes mellitus (T2DM) depression and anxiety status. 2.To explore the relationship between depression, glycated hemoglobin and lipid metabolism in patients with type 2 diabetes mellitus. 3. To explore the relationship between depression of patients with type 2 diabetes mellitus and coping styles.  In this paper, to choose 76 patients with clinical diagnosed type 2 diabetes, 37 patients from non diabetic disease group and 38 from health control group, three groups were evaluated respectively using Zung’s Self-Rating Depression Scale ( self-rating depression scale, SDS ), verified and inspected using the Self-rating Anxiety Scale ( self-rating anxiety scale, SAS ). Three groups were measured in the three groups of glycated hemoglobin ( HbA1-c ), triglyceride ( TG ), total cholesterol ( TC ), high density lipoprotein cholesterol ( HDL-C ),and low density lipoprotein cholesterol ( LDL-C ).And ,at the same time three groups were measured by the medical coping modes questionnaires (MCMQ) evaluation. Through the chi-square test data and analysis of variance, rank and inspection, and related analysis , the results show that: 1. T2DM with the diabetes disease group of higher rates of depression, anxiety, is the healthy controls 4-5 times. 2. T2DM with the diabetes disease of the group HbA1-c significantly higher than healthy controls, the HbA1-c T2DM group was significantly higher than the diabetes disease groups. 3. T2DM group and the diabetes disease group was significantly higher than the TG health control; T2DM group significantly lower than the control group TC; T2DM group of HDL-c significantly lower than the disease diabetes group and control group, the disease diabetes groups of HDL-c also significantly lower than those of the control group; The diabetes disease group of LDL-c significantly higher than healthy controls. 4. Three groups of whole of depression and age, anxiety, TG, yield was positively associated with HDL-c negatively, healthy controls and age of depression, anxiety, HbA1-c, TG was positively associated with face was negatively correlated; T2DM group of depression and age, anxiety, a positive correlation between yield, the diabetes disease group of depression and anxiety, yield were positively correlated. So that the conclusion: 1. In type 2 diabetes mellitus patients with anxiety and depression incidence is higher.2. Education in patients with T2DM disease should be strengthened and their blood glucose and blood lipid should be monitored and to prevent complications occurred; and at the same time their anxiety and depression should be screened; and the patients’ negative emotion needs timely psychological counseling so the patients can use positive manner facing disease and improve their quality of life. Figure 3, Table 12, references 48.
学科领域医学心理学
语种中文
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/20655
专题健康与遗传心理学研究室
作者单位中国科学院心理研究所
推荐引用方式
GB/T 7714
牛徐林. 2型糖尿病患者抑郁情绪与糖、脂代谢及其应对方式的分析[D]. 北京. 中国科学院研究生院,2012.
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