摘要
目的探讨心理压力和治疗依从性对自身免疫性肝炎(autoimmune hepatitis,AIH)患者发生类固醇糖尿病(steroid-induced diabetes mellitus,SDM)的影响。方法选择2017年1月至2022年7月在浙江省温州市中心医院诊治的130例AIH患者为研究对象,给予激素或激素联合硫唑嘌呤治疗。应用中文版知觉压力量表(Chinese perceived stress scale,CPSS)评估患者的心理压力情况。应用Morisky服药依从性调查问卷评估患者的服药依从性。患者每3个月进行血糖检测以诊断SDM。结果最终有128例患者纳入研究。AIH患者CPSS评分中位数(四分位间距)为37(30,40)。其中,压力过大者15例(11.7%),压力较大者89例(69.5%),压力正常者24例(18.8%)。AIH患者依从性评分为19(14,21),依从性差者56例(43.8%)。共有33例(25.8%)AIH患者发生SDM。Logistic多元回归显示,年龄增加、糖尿病家族史、高体重指数(BMI)、起始激素减量期>4周和压力过大是AIH患者发生SDM的独立危险因素。结论AIH患者存在较高的心理压力和SDM患病率,心理压力是影响SDM发生的独立危险因素。这为有针对性地制定护理策略、预防SDM提供了一定的依据。
Objective To investigate the effects of psychological pressure and treatment compliance on steroid-induced diabetes(SDM)in patients with autoimmune hepatitis(AIH).Methods A total of 130 AIH patients who were treated at Wenzhou Central Hospital in Zhejiang Province from January 2017 to July 2022 were selected as the research objects,and were treated with glucocorticoid or glucocorticoid combined with azathioprine.Chinese perceived stress scale(CPSS)was used to assess the psychological stress of patients.Morisky medication compliance questionnaire was used to evaluate the patient s medication compliance.Blood glucose were detected every 3 months to diagnose SDM.Results A total of 128 patients were included in the research.The median(interquartile interval)of CPSS score in AIH patients was 37(30,40).Among them,15 cases(11.7%)showed excessive pressure,89 cases(69.5%)showed high pressure,and 24 cases(18.8%)showed normal pressure.The compliance score in AIH patients was 19(14,21),and 56 patients(43.8%)showed poor compliance.A total of 33 patients(25.8%)developed SDM.Logistic multiple regression showed that increased age,family history of diabetes,high BMI,more than 4 weeks of initial hormone reduction time and excessive psychological pressure were independent risk factors for SDM in AIH patients.Conclusions AIH patients have high psychological pressure and prevalence of SDM.Psychological pressure is an independent factor that affects the occurrence of SDM.This provides a certain basis for formulating targeted nursing strategies and preventing SDM.
作者
白欣欣
周秀知
滕建燕
李易宸
胡春燕
BAI Xinxin;ZHOU Xiuzhi;TENG Jianyan;LI Yichen;HU Chunyan(Department of Critical Care Medicine,Wenzhou Central Hospital in Zhejiang Province,Wenzhou 325000,China)
出处
《浙江医学教育》
2024年第6期379-384,共6页
Zhejiang Medical Education
基金
2021年浙江省温州市基础性科研项目:“自身免疫性肝炎患者发生类固醇糖尿病的危险因素分析”(Y20210461)。
关键词
心理行为
自身免疫性肝炎
类固醇糖尿病
压力
依从性
Psychology and behavior
Autoimmune hepatitis
Steroid-induced diabetes mellitus
Pressure
Compliance
