护理干预对糖尿病抑郁患者糖皮质激素和糖脂代谢的影响

目的探讨护理干预对糖尿病抑郁患者糖皮质激素和糖脂代谢的影响。方法将68例糖尿病抑郁患者随机分为干预组38例和对照组30例。干预组在常规治疗与护理的同时给予心理干预、认知重建和社会支持，对照组给予常规治疗及护理。分别于干预前及干预后4周用抑郁自评量表（SDS）对2组患者进行评定，同时检测皮质醇、胰岛素、血糖、糖化血红蛋白（HbA1c）和血脂。结果干预前2组患者抑郁评分比较差异无统计学意义（P〉0．05），4N后干预组患者抑郁评分显著低于对照组（P〈0．05），平均皮质醇和空腹血糖、HbA1c、胰岛素、甘油三酯水平均低于对照组（P〈0．05）。结论护理干预有助于改善糖尿病抑郁患者的抑郁情绪，调节垂体肾上腺功能，改善血糖和血脂代谢水平。

Effect of nursing intervention on glucose and lipid metabolism in diabetic patients with depression

Objective To study the effect of nursing intervention on the plasma levels of cortisol,glucose and lipids in dia- betic patients with depression. Methods Sixty-eight diabetic patients with depression were randomly divided into interventional group （n=38） and control group （n=30）. The interventional group adopted systematic nursing intervention except conventional nursing care,while the control group adopted conventional nursing care. Before and after four-week intervention,SDS scale was used to evaluate the depression of the patients in the two groups. The plasma levels of fasting glucose,insulin,HbAlc,lipids and cortisol were measured in the meantime. Results There were no significant differences in the scores of SDS between the two groups （P〉0.05）. After four-week systematic nursing intervention,the SDS scores in the interventional group were significantly lower than those in the control group （P〈0.05）. The plasma levels of fasting glucose,insulin,HbAlc,triglyceride and cortisol were decreased in the interventional group than those in the control group. Conclusion Nursing intervention can effectively ameliorate the depression,regulate pituitary-adrenal axis function,and improve blood glucose and lipid metabolism in diabetic patients with depression.