CAJ | 학술논문

目的探讨口服降糖药常见不良反应低血糖和体重增加对2型糖尿病患者心理建康和生存质量的影响.方法全国16家三甲医院于2007年1至6月对486例2型糖尿病患者采用统一的患者问卷(AP RECAP-DM研究)进行病史采集,以低血糖担忧勘测量表(HFS-Ⅱ)测量患者治疗后对低血糖的担忧状况,欧洲生存质量五维量表(EQ-5D)测量患者治疗后的健康相关生存质量.结果 203例(41.8%)发生低血糖,其中18例(8.8%)为严重或极严重低血糖.93例(19.2%)有体重增加,其中11例(11.7%)体重增加超过5 kg.发生低血糖组HFS-Ⅱ分值高于无低血糖组[7.00(2.00～19.00)比0.00(0.00～7.00),P＜0.01]而EQ-5D健康指数低于未发生低血糖组(0.90±0.12比0.93±0.13,P=0.003),其中严重或极严重低血糖组HFS-Ⅱ分值高于轻度低血糖组[20.00(8.00～30.00)比5.00(0.00～14.00),P＜0.01].回归分析显示,HFS-Ⅱ分值与低血糖反应呈正相关(β=5.78,P＜0.01),EQ-5D健康指数与低血糖反应呈负相关(β=-0.04,P＜0.05),其中相对于轻度低血糖,严重低血糖或极严重低血糖组的HFS-Ⅱ分值较高(β=10.92,P＜0.01).结论在口服降糖药治疗过程中存在着较高的低血糖发生风险,与自我感觉不良和负性心理健康相关,有可能影响糖尿病远期预后.
목적 탐토구복강당약상견불량반응저혈당화체중증가대2형당뇨병환자심리건강화생존질량적영향.방법 전국16가삼갑의원우2007년1지6월대486례2형당뇨병환자채용통일적환자문권(AP RECAP-DM연구)진행병사채집,이저혈당담우감측량표(HFS-Ⅱ)측량환자치료후대저혈당적담우상황,구주생존질량오유량표(EQ-5D)측량환자치료후적건강상관생존질량.결과 203례(41.8%)발생저혈당,기중18례(8.8%)위엄중혹겁엄중저혈당.93례(19.2%)유체중증가,기중11례(11.7%)체중증가초과5 kg.발생저혈당조HFS-Ⅱ분치고우무저혈당조[7.00(2.00～19.00)비0.00(0.00～7.00),P＜0.01]이EQ-5D건강지수저우미발생저혈당조(0.90±0.12비0.93±0.13,P=0.003),기중엄중혹겁엄중저혈당조HFS-Ⅱ분치고우경도저혈당조[20.00(8.00～30.00)비5.00(0.00～14.00),P＜0.01].회귀분석현시,HFS-Ⅱ분치여저혈당반응정정상관(β=5.78,P＜0.01),EQ-5D건강지수여저혈당반응정부상관(β=-0.04,P＜0.05),기중상대우경도저혈당,엄중저혈당혹겁엄중저혈당조적HFS-Ⅱ분치교고(β=10.92,P＜0.01).결론 재구복강당약치료과정중존재착교고적저혈당발생풍험,여자아감각불량화부성심리건강상관,유가능영향당뇨병원기예후.
Objective To examine the association between the side effects of oral anti-diabetic drugs (OAD) and self-reported mental health and quality of life among patients with type 2 diabetes mellitus (T2DM). Methods An observational, cross-sectional multicenter study with a retrospective medical chart review was conducted at 16 medical centers from around China. The T2DM patients were followed-up and treated with OAD alone prior to the index visit from January to September 2007. All subjects were ≥30 years old at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Health-related quality of life was measured by the EuroQol-5D (EQ-5D) and Hypoglycemia Fear Survey (HFS) - Ⅱ. Results The symptoms of hypoglycemia were reported by 41.8% ( n = 203 ) of participants, and 19. 2% ( n = 93 ) experienced weight gain. For those reporting hypoglycemia, the scores were higher for HFS-Ⅱ [7.00(2.00 - 19.00)vs 0.00(0.00 -7.00), P ＜0.01] and lower for EQ-5D (0. 90 ± 0. 12 vs 0. 93 ± 0. 13, P = 0. 003 ) than those without hypoglycemic symptoms. According to the multivariate linear regression analysis, the symptoms of hypoglycemia were positively correlated with HFS- Ⅱ (β =5.78, P ＜0. 01 ) and negatively with EQ-5D (β = -0. 04, P ＜0. 05 ) after adjusting for patient and disease characteristics. Conclusion There is a high possibility of hypoglycemic risks among T2DM patients on OAD therapy. The self-reported hypoglycemia is associated with health-related quality of life and hypoglycemic fear. They may have an impact on the long-term prognosis.