陈才奖??孔丽瑶

[摘要]目的 探讨糖尿病性脑血管病患者与情绪障碍的高危险因素及其对预后的影响。 方法 将133例糖尿病性脑血管伴发情绪障碍的患者作为观察组；选择同时间就诊的129例无情绪障碍的糖尿病性脑血管病患者作为对照组；并比较两组的临床效果。 结果 两组患者FBG、PBG、HbA1C随治疗进行明显下降，观察组FBG治疗4周、24周后与对照组比较（t1=2.69，t2=2.90，P<0.05）；观察组的神经缺损程度和生活质量治疗前均重于对照组（t3=27.10，t4=-28.61，P<0.05）；观察组随着治疗的进行神经缺损程度与情感障碍得到明显改善（t4w=7.76，t24w=8.13，均P<0.05）；观察组随着治疗的进行生活质量逐渐的明显改善（t4w=-12.26，t24w=-13.12，均P<0.05）；观察组的SAS和SDS评分随治疗的进行逐渐降低，在4周、24周后与治疗前比较（SAS：t4w=7.37，t24w=7.10，SDS：t4w=5.85，t24w=5.58，P均<0.05））。 结论 情绪障碍的改善，有助于患者的血糖控制，可明显降低脑血管疾病的发生率和死亡率，可有效促进神经功能的康复及患者生活质量的提高。

[关键词]糖尿病性脑血管病；焦虑；抑郁；相互关系

[中图分类号] R587.2 [文献标识码] A [文章编号] 2095-0616（2014）14-10-03

A study of interrelations between diabetic cerebrovascular dsease and emotional disorders

CHEN Caijiang KONG Liyao

People's Hospital of the South China Sea Economic Development Zone， Foshan 528234， China

[Abstract] Objective To explore high-risk factors and their effects on prognosis for patients with diabetic cerebrovascular disease and emotional disorders. Methods 133 patients with diabetic cerebrovascular disease complicated with emotional disorders were selected as an observation group； 129 patients with diabetic cerebrovascular disease yet without emotional disorders who were diagnosed at the same period were selected as a control group. Clinical efficacy was compared between the two groups. Results FBG， PBG and HbA1C in the two groups significantly reduced with the treatment going on. FBG in the observation group at week 4 and week 24 of the treatment were compared with those in the control group （t1=2.69， t2=2.90， P<0.05）； nerval functional defects and life quality in the observation group before the treatment were both more severe than those in the control group （t3=27.10， t4=-28.61， P<0.05）； nerval functional defects and emotional disorders in the observation group greatly alleviated with the treatment going on （t4w=7.76， t24w=8.13， P<0.05 for both）； SAS and SDS scores in the observation group gradually lowered with the treatment going on， and the scores at week 4 and week 24 were compared with those before the treatment （SAS： t4w=7.37， t24w=7.10， SDS： t4w=5.85， t24w=5.58， P<0.05 for all）. Conclusion Alleviation of emotional disorders helps control patients blood sugar， significantly reduce incidence and mortality of cerebrovascular diseases and effectively promote the recovery of nerval functions and patients life quality.

[Key words] Diabetic cerebrovascular disease； Anxiety； Depression； Interrelationsendprint

糖尿病（diabetes mellitus，DM）是一种严重影响人类身体健康的心身疾病，脑血管病（cerebro vascular disease）是糖尿病最常见的合并症之一，除了躯体疾病影响患者生活质量外，患者焦虑、抑郁等负性情绪也是影响其生活质量的重要因素[1-2]。DM合并脑血管病临床治疗严格控制血糖是提高疗效、降低脑卒中患者死亡率的关键[3]。同时DM也

直接影响脑血管病的临床表现、病情严重程度以及预后等方面。DM患者脑卒中的病死率、病残率、复发率较高，病情恢复慢[4]。DM患者更易出现焦虑、抑郁等情绪障碍，发病率高达50%以上，情绪障碍造成血糖升高，血糖难控制又影响患者情绪，造成恶性循环[5]。糖尿病性脑血管病的情绪障碍高危险因素早期干预治疗对患者预后及生活质量至关重要。

1 资料与方法

1.1 一般资料

选择2011年2月～2013年12月我院收治的133例糖尿病脑性脑血管伴发情绪障碍的患者作为观察组，其中男75例，女58例，年龄33～78岁，平均（58.7±3.1）岁；选择同时间就诊的129例无情绪障碍的糖尿病性脑血管病患者作为对照组，将所有患者随机分为观察组与对照组，两组均符合1999年WHO制定的糖尿病诊断标准[6]；……