·糖尿病视网膜病变·

　　【摘要】 目的 评价DR合并抑郁状态患者的生命质量和人格特征，探讨其炎症因子变化。 方法 选取新诊断DR(背景期)患者164例，按照抑郁自评量表(SDS)评分分为抑郁状态(DRD)组114例和非抑郁状态(N-DRD)组50例，采用艾森克人格量表和糖尿病生命质量量表评价，检测生化指标和炎症因子。 结果 DR合并抑郁状态患病率69.51%。与N-DRD组相比，DRD组满意程度[(36.70±8.38)vs(29.92±8.15)分]、影响程度[(47.51±11.29)vs(39.60±10.37)分]、忧虑程度Ⅰ[(13.56±7.37)vs(8.28±2.39)分]、忧虑程度Ⅱ[(9.23±4.24)vs(5.80±2.22)分]、神经质[(4.56±3.33)vs(1.84±2.06)分]得分高，内外向[(7.98±3.15)vs(9.60±2.65)分]得分低;病程、SBP、FPG、HbA1c、TG、高敏C反应蛋白(hsC-RP)、IL-6、TNF-α、皮质醇和HOMA-IR水平均增高(P均<0.05)。SDS评分与hsC-RP、TNF-α呈正相关。 结论 DR易合并抑郁状态，且神经质、内向性格、生命质量低者更易导致抑郁状态，hsC-RP和TNF-α是抑郁状态的独立影响因素。

　　【关键词】糖尿病视网膜病变;抑郁状态;生命质量;人格特征;肿瘤坏死因子α

Clinical assessment of diabetic retinopathy patient with depression HOU Ning-ning, LIU Yan, SUN Jin-zhi, et al. Department of Endocrinology, The Affiliated Hospital of Weifang Medical College, Weifang 261041, China

Corresponding author: SUN Xiao-dong, E-mail:sxdfriend@sina.com

　　【Abstract】Objective To evaluate the quality of life and personality characteristics, and to explore the change of inflammatory cytokines in DR patients with depression. Methods The 164 newly diagnosed DR patients (background period), according to the deprsssion self-rating scale (SDS), were divided into depression (DRD, n=141) group and non-depression group (N-DRD, n=50) group. They were evaluated with the "Eysenck personality questionaire" and "Adjusted diabetes-specific quality of life scale". The measurement of plasma biochemical markers and inflammatory factors were done for analysis. Results The prevalence of DR accompanied with depression was 69.51%. Compared with N-DRD group, the DRD group showed the higher scores of satisfaction [(36.70±8.38)vs(29.92±8.15)],influence[(47.51±11.29)vs(39.60±10.37)],anxietyⅠ [(13.56±7.37) vs (8.28±2.39)], anxiety Ⅱ[(9.23±4.24)vs(5.80±2.22)], neuroticism[(4.56±3.33)vs(1.84±2.06)],and lower score of extraversion [(7.98±3.15)vs(9.60±2.65)]. The course of disease, SBP, FPG, HbA1c, TG, hsC-RP, IL-6, TNF-α, Cortisol and HOMA-IR were significantly higher in DRD group than in N-DRD group (P<0.05). The SDS score was positively correlated with TNF-α and hsC-RP. Conclusion DR is likely to be accompanied with depression. Those with poor quality of life who are in intra-version and neuroticism personality are more easily to be in the depressed state. Serum levels of hsC-RP and TNF-α are the important impact factors of DR-associated depression.

　　【Key words】Diabetic retinopathy (DR);Depression;Quality of life;Personality;Tumor necrosis factor-α (TNF-α)