抗抑郁治疗对老年糖尿病伴抑郁症状患者胰岛素敏感性的影响

目的探讨应用抗抑郁药物干预抑郁症状对糖尿病患者胰岛素敏感性的影响及临床意义。方法采用Zung抑郁自评量表（SDS）选择糖尿病伴抑郁症状患者82例,其中45例作为研究组,给予抗抑郁药物治疗6个月;另有37例病人未接受抗抑郁药物治疗作为对照组。观察治疗前后患者的SDS评分;空腹血糖（FPG）、空腹胰岛素水平（FIN）、糖化血红蛋白（GHbA1C）等生化指标;及治疗前后病人治疗（糖尿病）依从性变化。结果经6个月治疗研究组病人SDS评分显著降低（P〈0.01）,FPG、FIN、GHbA1C均有明显下降（P〈0.01,P〈0.05）,空腹血浆皮质醇（FC）水平无变化,运动频率、运动时间、就诊次数增加有统计学意义（P〈0.01）,漏服药物及不按时按量进餐次数减少有统计学意义（P〈0.01）,胰岛素敏感性升高（P〈0.05）。对照组上述各指标无变化。结论抗抑郁药物可改善抑郁症状,提高病人治疗依从性,并通过增加病人活动改善老年糖尿病患者的胰岛素敏感性。

Antidepression could Enhance the Insulin Sensitivity In Old Diabetic Patients With Depressive Symptoms

Objective To study the effect of antidepression on insulin sensitivity of patients with diabetes mellitus and its clinical value.Methods A total 82 diabetes patients as study group accompanied with depression symptoms enrolled the study by means of Self-rating Depression Scale(SDS).45 patients who were treated with antidepression for a treatment of 6 months was study group.The other 37 patients who were inefficiently treated with antidepression was control group.SDS,FBG,FIN,and GHbA1C were measured before and after treatment.Results: In study group,the score of SDS,levels of FBG,FINand GHbA1C significantly decreased after 6-month treatment(P<0.01),while the level of FC had no significant change.After treatment frequency of movment,time of movement,and frequency to see the doctor were significantly larger than before treatment,while times of missing drugs and irregular deal were lower,and insulin sensitivity significantly increased.In control group there were no significant change in all the observed information.Conclusion: Antidepression could effectively ameliorate depressive symptoms and increase insulin sensitivity of elder patients with diabetes mellitus by increasing activities.