摘要
目的研究持续皮下胰岛素输注(continuous subcutaneous insulin infusion,CSII)对1型糖尿病(type 1 diabetes mellitus,T1DM)儿童青少年及家长情绪状况的影响。方法72例T1DM儿童青少年及其家长依据强化治疗方式分为CSII组(40例)和每日多次皮下胰岛素注射(multiple daily insulin,MDI)组(32例),58例健康儿童青少年及其家长为对照组。以儿童抑郁障碍自评量表和儿童焦虑性情绪障碍筛查表评估所有儿童青少年情绪状况,以90项症状自评量表评估家长心理健康状况。结果T1DM儿童青少年糖化血红蛋白达到良好水平[HbA1c,(7.406±1.294)%],CSII组明显优于MDI组[(7.040±1.082)%比(7.863±1.404)%,t=2.728,P=0.008]。T1DM组儿童青少年抑郁检出率高于对照组(31.9%比15.5%,χ^(2)=4.671,P=0.031);CSII组、MDI组、对照组儿童青少年抑郁检出率差异有统计学意义(20.0%比46.9%比15.5%,χ^(2)=11.591,P=0.003);MDI组儿童青少年抑郁检出率高于CSII组和对照组,差异均有统计学意义(均P<0.05);CSII组与对照组差异无统计学意义(P>0.05)。T1DM组和对照组儿童青少年焦虑检出率差异无统计学意义(19.4%比13.8%,χ^(2)=0.730,P=0.393),CSII组、MDI组和对照组三组间差异无统计学意义(15.0%比25.0%比13.8%,χ^(2)=1.994,P=0.369)。T1DM组家长情绪障碍检出率显著高于对照组的检出率(31.9%比5.2%,χ^(2)=52.927,P<0.001),其中T1DM组家长在强迫、人际关系敏感、抑郁、焦虑、敌对、偏执、精神病性维度的因子分高于对照组家长(P<0.05);CSII组、MDI组、对照组家长情绪障碍检出率差异有统计学意义(17.5%比50.0%比5.2%,χ^(2)=26.126,P<0.01);MDI组家长情绪障碍检出率高于CSII组和对照组,差异均有统计学意义(均P<0.05);CSII组和对照组差异无统计学意义(P>0.05)。结论T1DM儿童青少年及其家长是情绪障碍的高危人群,CSII可以降低T1DM儿童青少年抑郁的发生以及家长情绪障碍的发生,改善糖尿病家庭的心理健康。
Objective To study the effect of continuous subcutaneous insulin infusion(CSII)on the emotional disorder of children and adolescents with type 1 diabetes mellitus(T1DM)and their parents.Methods A total of 72 children and adolescents with T1DM were divided into CSII group(n=40)and multiple daily injection(MDI)group(n=32).There were 58 healthy children and adolescents with their parents selected as control group.The emotional condition of children and adolescents in T1DM group and control group was evaluated by Depression Self-rating Scale for Children(DSRS)and the Screen for Child Anxiety Related Emotional Disorders(SCARED)respectively,and Symptom Checklist-90(SCL-90)was used for evaluating the mental health of all parents.Results The average glycated hemoglobin A1c(HbA1c)of T1DM group was at the optimal level(7.406±1.294)%.The average HbA1c of CSII group was significantly lower than that of MDI group[(7.040±1.082)%vs(7.863±1.404)%,t=2.728,P=0.008].The depression rate of children and adolescents in T1DM group increased significantly than that of control group(31.9%vs 15.5%,χ^(2)=4.671,P=0.031).There were statistically significant differences among CSII group,MDI group and control group(20.0%vs 46.9%vs 15.5%,χ^(2)=11.591,P=0.003).The depression rate of children and adolescents in MDI group increased significantly than that of CSII group and control group(all P<0.05).CSII group showed similar results as compared with control group(P>0.05).Concerning the anxiety in children and adolescents,there was no significant difference between T1DM group and control group(19.4%vs 13.8%,χ^(2)=0.730,P=0.393),and there were no significant differences among CSII group,MDI group and control group(15.0%vs 25.0%vs 13.8%,χ^(2)=1.994,P=0.369).The emotional disorder prevalence of parents in T1DM group was remarkably higher than that of the control group(31.9%vs 5.2%,χ^(2)=52.927,P<0.01).The factor scores of obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,paranoia and psychotic symptoms in T1DM
作者
王丽娜
冯雪英
张丽娟
慕佳霖
陈志红
Wang Lina;Feng Xueying;Zhang Lijuan;Mu Jialin;Chen Zhihong(Pediatric Endocrinology and Gastroenterology,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Children′s Health Section,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)
出处
《国际儿科学杂志》
2023年第2期135-140,共6页
International Journal of Pediatrics
基金
青岛市民生科技计划项目(18-6-1-72-nsh)。
关键词
1型糖尿病
儿童青少年
家长
持续皮下胰岛素输注
情绪障碍
Type 1 diabetes mellitus
Children and adolescents
Parents
Continuous subcutaneous insulin infusion
Emotional disorder
