标题：社区2型糖尿病患者治疗依从性、病情发展及其抑郁和焦虑状态的调查

      作者：徐雯 1，管佳希 1，吴娟丽 1，郭旋 2，胡颖 3，郑羽翔 1    1.上海市同济大学附属杨浦区大桥社区卫生服务中(筹)心内科，上海 200090；2.上海市同济大学附属杨浦医院，上海 200090；3.上海交通大学医学院附属新华医院消化科，上海 200090

      卷次： 2019年30卷8期

      【摘要】 目的 调查大桥社区2型糖尿病患者治疗依从性、病情发展与其抑郁和焦虑状态。方法 于2017年1月至2018年12月，采用随机抽样法抽取大桥社区服务中心接收的371例2型糖尿病患者为研究对象，采用自制调查问卷搜集大桥社区2型糖尿病患者基本资料、治疗依从性、疾病控制情况；采用汉密尔顿抑郁量表(HAMD)及焦虑量表(HAMA)评估受试者抑郁、焦虑状态。疾病控制情况包括测定患者糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后 2 h血糖(2 hPG)等血糖相关指标。结果 大桥社区男性患者的治疗依从率为 77.97%，明显低于女性的89.01%，差异具有统计学意义(P<0.05)；大桥社区男性患者HbA1c、FPG、2 hPG等血糖控制相关指标达标率均低于女性(HbA1c：16.95% vs 25.43%；FPG：18.08% vs 22.54%；2 hPG：16.95% vs 25.43%)，差异均有统计学意义(P<0.05)；大桥社区男性、女性2型糖尿病患者的HAMA评分[(8.84±0.71)分 vs (8.78±0.68)分]、HAMD评分[(8.76±0.52)分 vs(8.80±0.61)分]比较差异均无统计学意义(P>0.05)。结论 大桥社区2型糖尿病患者治疗依从性女性高于男性，但全部患者血糖控制情况仍有待提高，部分患者出现抑郁、焦虑的不良情绪；社区医务人员应加强对大桥社区2型糖尿病患者的健康教育，帮助其控制疾病发展、改善不良情绪
      【关键词】 2型糖尿病；社区；治疗依从性；疾病控制；焦虑；抑郁
      【中图分类号】 R587.1 【文献标识码】 D 【文章编号】 1003—6350（2019）08—1073—03

Investigation of treatment compliance, disease development, and depression and anxiety in patients with type 2diabetes mellitus in community.
XU Wen 1, GUAN Jia-xi 1, WU Juan-li 1, GUO Xuan 2, HU Ying 3, ZHENG Yu-xiang 1.1. Department of Internal Medicine, the Affiliated Yangpu District Daqiao Community Health Service Center of ShanghaiTongji University, Shanghai 200090, CHINA; 2. The Affiliated Yangpu Hospital of Shanghai Tongji University, Shanghai200090, CHINA; 3. Department of Gastroenterology, the Affiliated Xinhua Hospital of Shanghai Jiaotong University Schoolof Medicine, Shanghai 200090, CHINA
【Abstract】 Objective To investigate the treatment compliance, disease development, depression and anxietyof type 2 diabetes mellitus patients in Daqiao community. Methods From January 2017 to December 2018, 371 pa-tients with type 2 diabetes mellitus treated in Daqiao Community Service Center were selected by random samplingmethod. The basic data, treatment compliance, and disease control of type 2 diabetes mellitus in Daqiao Communitywere collected by self-made questionnaire. The depression and anxiety symptoms were assessed by Hamilton DepressionScale (HAMD) and Hamilton Anxiety Scale (HAMA). Disease control state were determined by testing glycosylated he-moglobin (HbA1c), fasting blood glucose (FPG), postprandial 2 h blood glucose (2 hPG), and other blood sugar relatedindicators. Results The compliance rate of male patients in Daqiao community was 77.97%, which was significantlylower than 89.01% of female patients (P<0.05). In Daqiao community, the compliance rates of HbA1c, FPG, and 2 h PGin male patients were lower than those in female patients (HbA1c: 16.95% vs 25.43%; FPG: 18.08% vs 22.54%; 2 h PG:16.95% vs 25.43%), all with statistically significant differences (P<0.05). There was no significant difference in HAMAscore and HAMD score between male and female patients with type 2 diabetes mellitus in Daqiao community: (8.84±0.71) vs (8.78±0.68), P>0.05; (8.76±0.52) vs (8.80±0.61), P>0.05. Conclusion The treatment compliance of womenwith type 2 diabetes mellitus in Daqiao community is higher than that of men, but the blood sugar control of all patientsstill needs to be improved. Some patients have bad moods of depression and anxiety. Community medical staff shouldstrengthen health education for type 2 diabetes mellitus in Daqiao community to help them control disease developmentand improve bad mood.
      【Key words】 Type 2 diabetes mellitus; Community; Treatment compliance; Disease control; Anxiety; Depression·调查研究·doi:10.3969/j.issn.1003-6350.2019.08.034基金项目：上海市同济大学医学院社区慢病管理研究项目(编号：TYS2018M003)