抑郁症共病糖尿病患者皮质醇水平与帕罗西汀治疗疗效评价.docVIP

抑郁症共病糖尿病患者皮质醇水平与帕罗西汀治疗疗效评价 　　【摘要】 目的：观察帕罗西汀治疗抑郁症共病糖尿病患者的临床效果，并测定患者皮质醇水平与其治疗效果之间的相关性。方法：选择2014年1月-2016年1月本院收治的120例抑郁症共病糖尿病患者为观察对象，皮质醇升高组52例，皮质醇正常组68例，两组均接受帕罗西汀治疗，回顾分析患者的临床疗效。结果：治疗后，皮质醇升高组的HAMD评分高于皮质醇正常组，HAMD减分率低于皮质醇正常组，差异均有统计学意义（P12个月。结论：抑郁症共病糖尿病患者的主要危险因素包括糖化血红蛋白、HAMD评分、体质量指数、年龄等，需要针对各项危险因素，采取相应的调节和控制措施，从而保证帕罗西汀的临床治疗效果。 　　【关键词】 抑郁症； 糖尿病； 皮质醇； 帕罗西汀 　　【Abstract】 Objective：To observe the clinical effect of Paroxetine in the treatment of diabetic patients with depression，and to determine the correlation between the level of cortisol and its treatment effect.Method：120 diabetic patients with depression in our hospital from January 2014 to January 2016 were observed as the research objects，cortisol increased groupin 52 cases，68 cases of normal cortisol group，two groups were treated with paroxetine，the clinical efficacy of patients was retrospectively analyzed.Result：The HAMD score was higher than that in normal group，HAMD reduction rate was significantly lower than that in normal group，the differences were statistically significant （P0.05）.The risk factors of depression in patients with comorbid diabetes elevated cortisol levels of HbA1c is more than 8%，more than 20 points of HAMD score and body mass index was greater than 25 kg/m2， 　　age 35 to 50 years of age；the protective factors include exercise time per week for more than 4 h，the course of depression for more than 12 months.Conclusion：The depression risk factors in diabetic patients including glycosylated hemoglobin，HAMD score，body mass index，age，the need for the regulation and control of risk factors，take corresponding measures，so as to ensure the clinical therapeutic effect of paroxetine. 　　【Key words】 Depression； Diabetes； Cortisol； Paroxetine 　　First-author’s address：The Third People’s Hospital of Ganzhou City，Ganzhou 341000，China 　　doi：10.3969/j.issn.1674-4985.2016.36.030 　　抑郁?Y是当前临床极为常见的一种精神疾病类型。临床研究显示，糖尿病患者并发抑郁症的概率约为正常人群的3倍以上，同时该类患者存在极为明显的躯体化症状[1]。对其原因进行分析，发现抑郁症共病糖尿病患者表现出明显的皮质醇水平异常升高症状，而当前临床针对这一现象的诱发机制