摘要目的 对比分析有无视网膜病变的糖尿病患者焦虑、抑郁状态及人格特征.方法 2014年4～11月昆明医科大学第二附属医院内分泌科及眼科收治的糖尿病患者435例纳入研究.其中,伴有视网膜病变178例(A组),不伴有视网膜病变257例(B组).采用调查问卷的方式收集患者一般资料.由眼科医生应用焦虑自评量表(SAS)、抑郁自评量表(SDS)、大五人格量表(NEO-FFI)对患者进行评估和统计分数,最后评定两组患者的焦虑、抑郁状态以及人格特征.根据分值不同,将SAS分为轻度焦虑、中度焦虑、重度焦虑;SDS分为无抑郁、轻度抑郁、中度抑郁、重度抑郁.NEO-FFI从情绪稳定性、外向、开明性、随和、责任心5个方面进行测定.同时,以伴有视网膜病变为因变量,以文化程度、伴高血压、年龄、饮酒、职业等因素为自变量,采用多元线性回归分析法分析视网膜病变发生的影响因素.结果 A组患者中,轻度焦虑110例,中度焦虑57例,重度焦虑11例;无抑郁74例,轻度抑郁53例,中度抑郁31例,重度抑郁20例.B组患者中,轻度焦虑181例,中度焦虑53例,重度焦虑23例;无抑郁177例,轻度抑郁44例,中度抑郁25例,重度抑郁11例.A组SAS、SDS评分均较B组明显偏高,差异有统计学意义(P=0.035).A、B组患者NEO-FFI评分结果比较,B组患者在外向、随和、责任心方面的评分较A组更高,差异有统计学意义(P=0.022);B组患者在情绪稳定方面的评分较A组低,差异有统计学意义(P=0.014);两组患者在开明性方面的评分无明显差异(P=0.210).多元线性回归分析结果显示,文化程度、伴高血压、年龄、体重、饮酒、职业的忙绿程度均是视网膜病变发生的影响因素(P=0.019).结论 与无视网膜病变者比较,有视网膜病变的糖尿病患者更容易焦虑、抑郁,且在外向、随和、责任心等人格特征方面评分较低.

abstractsObjective To compare the anxiety,depressive and personality characteristics between diabetes mellitus patients with or without diabetic retinopathy (DR),and look for psychological treatment and corresponding prevention measures.Methods 435 diabetic patients were enrolled in this study from April to November 2014 in our hospital,including 178 DR cases (group A) and 257 cases without retinopathy (group B).All the patients completed a questionnaire,the Self-Rating Anxiety (SAS),the SelfRating Depression Scale (SDS) and the big five personality scale (NEO-FFI),and were scored by eye doctors.According to the score,SAS can be divided into mild anxiety,moderate anxiety,and severe anxiety.SDS is divided into depression,mild depression,moderate depression and major depression.NEO-FFI was scored from emotional stability,outgoing,openness,easy-going and sense of responsibility.Multiple linear regression analysis was used to analyze the DR risk factors in those scores and education level,high blood pressure,age,alcohol consumption,occupation and other factors.Results There were 110 cases of mild anxiety,57 cases of moderate anxiety,11 cases of severe anxiety;74 cases without depression,53 cases of mild depression,31 cases of moderate depression,20 cases with major depression in group A.There were 181 cases of mild anxiety,53 cases of moderate anxiety,23 cases of severe anxiety;177 cases without depression,44 cases of mild depression,25 cases of moderate depression,11 case with major depression in group B.Group A patients had higher SAS,SDS scores than group B,the difference was statistically significant (P =0.035).Group B patients had higher NEO-FFI score in outgoing,easygoing,responsibility (P=0.022),lower NEO-FFI score in emotional stability (P=0.014) and same NEO-FFI score in openness(P =0.210)compare to Group A patients.Multiple linear regression analysis results showed that education level,high blood pressure,age,weight,drinking,occupation can affect the degree of changes in the retina (P=0.019).Conclusions Compared with those without retinopathy,DR patients were more prone to anxiety and depression.They also had low score in personality characteristics of outgoing,easygoing,responsibility.