摘要
目的调查老年2型糖尿病(T2DM)患者合并胃肠自主神经病变的现状,并探讨其影响因素。方法采用便利抽样法选取2022年8月—2023年5月在延安大学附属医院、吴起县人民医院内分泌科住院的老年T2DM患者作为研究对象。采用一般资料调查表、复合自主神经症状评分-31(COMPASS-31)、Zung焦虑自评量表(SAS)、Zung抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)收集资料;使用风险比值比(OR)分析老年T2DM患者胃肠自主神经病变与其心理状况和睡眠质量间的风险关系;通过二元logistic回归分析老年T2DM患者合并胃肠自主神经病变的危险因素。结果共纳入324例患者,其中188例(58.02%)患者合并胃肠自主神经病变(COMPASS-31量表得分≥1分)。合并胃肠自主神经病变患者中73.9%(139/188)的患者存在便秘情况,占比最高,49.5%(93/188)的患者存在胃部自主神经病变相关症状,主要表现为早饱或餐后饱胀;18.10%(34/188)的患者存在腹泻,有腹泻/便秘交替现象的患者占9.04%(17/188)。在胃肠自主神经病变患者中,便秘维度:63.3%(88/139)的患者便秘频率为频繁或持续不断,79.9%(111/139)的患者便秘严重情况为中重度水平;胃部症状维度:72.0%(67/93)的患者早饱感或饭后饱胀感较为严重;腹泻维度:在有腹泻的患者中47.1%(16/34)的患者腹泻频率为频繁或持续不断,73.5%(25/34)的患者腹泻严重情况为中重度水平。合并胃肠自主神经病变患者焦虑、抑郁发生率分别为16.0%、41.5%,睡眠质量差(PSQI 11~21分)的发生率为42.0%,发生风险分别是无胃肠自主神经病变患者的8.414倍、6.179倍、3.218倍。二元logistic回归分析结果显示,低密度脂蛋白(OR=0.502)、病程(病程在10~19年OR=2.282、病程在20年及以上OR=3.406)、抑郁(OR=6.075)是老年T2DM患者合并胃肠自主神经病变的独立影响因素(P均<0.05)。结论老年T2DM患者合并胃肠自主神经病变发生率较高,最常见的症状是便�
Objective To investigate the status of gastrointestinal autonomic neuropathy in elderly patients with type 2 diabetes mellitus(T2DM),and to explore the influencing factors of gastrointestinal autonomic neuropathy in elderly pa-tients with T2DM.Methods Convenience sampling was used to select elderly T2DM patients admitted to the Endocrinol-ogy Department of Yan'an University Affiliated Hospital and Wuqi County People's Hospital from August 2022 to May 2023 as the research subjects.General data questionnaire,Complex autonomic Symptom Score 31(COMPASS-31),Zung Self-rating Anxiety Scale(SAS),Zung Self-rating Depression Scale(SDS)and Pittsburgh Sleep Quality Index(PSQI)were used to collect data.Risk odds ratio(OR)was used to analyze the risk relationship between gastrointestinal autonom-ic neuropathy,psychological status and sleep quality in elderly patients with T2DM.The risk factors of gastrointestinal au-tonomic neuropathy were analyzed by binary logistic regression.Results A total of 324 patients were included,of which 188 cases(58.02%)had concomitant gastrointestinal autonomic neuropathy(COMPASS-31 score≥1);73.9%(139/188)of patients with combined gastrointestinal autonomic neuropathy had constipation,accounting for the highest proportion;49.5%(93/188)had symptoms related to gastric autonomic neuropathy,mainly manifested as early satiety or postprandial fullness;18.10%(34/188)had diarrhea,and 9.04%(17/188)had alternating diarrhea/constipation.Among patients with gastrointestinal autonomic neuropathy,63.3%(88/139)had frequent or persistent constipation fre-quency,and 79.9%(111/139)had moderate to severe constipation severity;Stomach symptom dimension:72.0%(67/93)experienced severe early satiety or postprandial bloating;Diarrhea dimension:Among patients with diarrhea,47.1%(16/34)had frequent or persistent diarrhea frequency,and 73.5%(25/34)had moderate to severe diarrhea se-verity.The incidence of anxiety and depression in patients with gastrointestinal autonomic neuropathy was 16.0%and 41.5%,respectively,and the
作者
刘雪莉
贠秀俐
蒋娜娜
LIU Xueli;YUN Xiuli;JIANG Nana(School of Medicine,Yan'an University,Yan'an 716000,China;Department of Nursing,Wuqi County People's Hospital,Wuqi 717600,China;Department of Nursing,Yan'an University Affiliated Hospital,Yan'an 716000,China;Department of Hemodialysis,Wuqi County People's Hospital,Wuqi 717600,China)
出处
《老年医学研究》
2024年第4期1-8,共8页
Geriatrics Research
关键词
胃肠自主神经病变
2型糖尿病
焦虑
抑郁
睡眠质量
老年人
gastrointestinal autonomic neuropathy
type 2 diabetes
anxiety
depression
sleep quality
aged
