糖尿病前期患者焦虑现状调查及影响因素分析

背景　中国目前可能有多达1.139亿成年人糖尿病患者，近5亿糖尿病前期患者，而糖尿病患者伴发焦虑的患病率为40%，远高于健康人群。但是，目前关于糖尿病前期患者焦虑的研究较少。目的　通过对糖尿病前期患者焦虑情绪的调查分析，明确糖尿病前期患者焦虑现状，分析其影响因素，为糖尿病前期患者的心理干预提供科学依据。方法　选取2015年3—9月于江西省人民医院内分泌科门诊或体检科体检行口服葡萄糖耐量试验（OGTT）检查并筛查出的糖尿病前期患者100例为研究对象，使用自编一般情况调查表及焦虑自评量表（SAS）对其进行问卷调查，并进行临床指标检测。按照SAS评分结果将其分为非焦虑组与焦虑组，比较两组间的差异，采用多因素Logistic回归分析糖尿病前期患者焦虑的影响因素。结果　共发放问卷100份，回收有效问卷100份，有效回收率为100.0%。100例糖尿病前期患者中，焦虑组22例（22.0%），其中轻度焦虑20例（90.9%），中度焦虑2例（9.1%），非焦虑组78例（78.0%）。两组患者家庭月收入、体质指数（BMI）比较，差异均有统计学意义（P<0.05）。糖尿病前期患者焦虑与家庭月收入（rs=-0.256）呈负相关（P<0.05），与性别（rs=0.026）、年龄（rs=-0.160）、文化程度（rs=0.100）、医疗保险类型（rs=0.140）、BMI（rs=0.142）、吸烟（rs=0.095）、饮酒（rs=0.027）、颈动脉硬化（rs=0.167）、下肢动脉硬化（rs=0.077）、糖尿病家族史（rs=0.049）、高血压（rs=0.061）、高脂血症（rs=0.032）、空腹血糖（FPG）（rs=0.122）、餐后2 h血糖（2 hPG）（rs=0.034）、糖化血红蛋白（HbA1c）（rs=0.121）无直线相关关系（P>0.05）。多因素Logistic回归分析结果显示，家庭月收入〔OR=1.636，95%CI（1.010，2.648）〕是糖尿病前期患者焦虑的影响因素（P=0.045）。结论　糖尿病前期患者普遍存在焦虑情绪，家庭月收入是影响其情绪的主要因素。因此，临床工作中应重视经济条件相对较差的患者群体，加强早期筛查并尽早行干预措施。

The Incidence and Influential Factors of Anxiety in Pre-diabetic Patients

Background　At present，there may be as many as 113.9 million adult diabetic patients and nearly 500 million pre-diabetic patients in China.The prevalence of anxiety in diabetic patients is 40%，which is much higher than that in healthy people.However，there are few studies on anxiety in pre-diabetic patients.Objective　To clarify the anxiety status of pre-diabetic patients through the investigation and analysis of anxiety in pre-diabetic patients，and analyze its influential factors，so as to provide scientific basis for psychological intervention of pre-diabetic patients.Methods　A total of 100 pre-diabetic patients screened by oral glucose tolerance test （OGTT） from March to September 2015 in the outpatient of endocrinology or physical examination department of Jiangxi Provincial People's Hospital were selected as the research objects.The self-designed questionnaire about general situation and self-rating anxiety scale （SAS） were used to carry out the questionnaire survey，and the clinical indicators were tested.According to the results of SAS score，subjects were divided into non anxiety group and anxiety group.The differences between the two groups were compared.The influential factors of anxiety in pre-diabetic patients were analyzed by multivariate logistic regression.Results　Atotal of 100 questionnaires were distributed and 100 valid questionnaires were collected，with the valid rate of 100.0%.There were 22 patients （22.0%）in the anxiety group，including 20 patients （90.9%）were mild anxiety，2 patients （9.1%）were moderate anxiety，and there were 78 patients （78.0%）in the non anxiety group．There were significant differences in monthly income and body mass index（BMI）between the two groups（P<0.05）．Anxiety was negatively correlated with family monthly income（rs=-0.256，P<0.05），and had no linear correlation with sex（rs=0.026），age（rs=-0.160），education level（rs=0.100），types of medical insurance（rs=0.140），BMI（rs=0.142），smoking （rs=0.095），alcohol consumption（rs=0.027），carotid atherosclerosis （rs=0.167），lower extremity atherosclerosis（rs=0.077），family history of diabetes（rs=0.049），hypertension（rs=0.061），hyperlipidemia （rs=0.032），FPG（rs=0.122），2 hPG（rs=0.034），HbA1c（rs=0.121，P>0.05）．Multivariate logistic regression analysis showed that family monthly income 〔OR=1.636，95%CI（1.010，2.648）〕was the influential factor of anxiety in pre-diabetic patients（P=0.045）．Conclusion　Anxiety is prevalent in pre-diabetic patients，and family monthly income is the main factor influencing their emotions.Therefore，doctors should pay attention to patients with relatively poor economic conditions，strengthen early screening and early intervention measures.