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目的探讨25(OH)D3水平对2型糖尿病抑郁症病情的影响,为临床治疗提供新思路。方法选择在该院住院治疗的2型糖尿病抑郁症患者,分为A、B二组,A组给予口服阿法骨化醇0.5μg/d,疗程4周。B组未给予口服阿法骨化醇。二组患者在住院当天和4周后分2次采集空腹外周静脉血5ml。血清中25(OH)D3水平测定采用化学发光法。认定70~80 nmol/L为正常水平。结果二组患者25(OH)D3水平、空腹及餐后血糖、抑郁量表评分等在补充阿法骨化醇前差异无统计学意义(P>0.05)。补充阿法骨化醇后,A组各项指标明显低于B组,随着25(OH)D3水平的升高A组患者抑郁评分明显降低,抑郁症状减轻,血清25(OH)D3水平与抑郁量表评分呈负相关(P<0.01),说明补充阿法骨化醇能改善抑郁症状,改善糖尿病血糖水平,差异有统计学意义(P<0.05)。结论维生素D可以改善2型糖尿病抑郁症患者的抑郁状态,减轻症状,是一种有效的治疗方法,可提高糖尿病抑郁症患者的生活质量。对2型糖尿病抑郁症患者进行血清25(OH)D3水平监测,并及时补充阿法骨化醇,为临床治疗提供了新思路。
Objective To investigate the effect of 25 (OH) D3 on depression in patients with type 2 diabetes and to provide new ideas for clinical treatment. Methods Patients with type 2 diabetes mellitus who were hospitalized in this hospital were divided into two groups A and B. Group A was given oral alfacalcidol 0.5μg / d for 4 weeks. B group was not given oral alfacalcidol. Two groups of patients were collected on the day of hospitalization and 4 weeks after 2 fasting peripheral venous blood 5ml. Serum 25 (OH) D3 levels were determined by chemiluminescence method. 70 ~ 80 nmol / L is considered normal. Results There were no significant differences in the levels of 25 (OH) D3, fasting and postprandial blood glucose and depression scale scores between the two groups before supplementation with alfacalcidin (P> 0.05). After adding alfacalcidol, the indexes in group A were significantly lower than those in group B. As the level of 25 (OH) D3 increased, the scores of depression and depression in group A were significantly decreased, while the levels of serum 25 (OH) D3 and Depression scale score was negatively correlated (P <0.01), indicating that supplementation of alfacalciferol can improve depression symptoms and improve blood glucose levels of diabetes, the difference was statistically significant (P <0.05). Conclusion Vitamin D can improve depression and relieve symptoms in patients with type 2 diabetes mellitus. It is an effective treatment to improve the quality of life in patients with diabetes mellitus. In patients with type 2 diabetes mellitus, serum 25 (OH) D3 levels are monitored and alfacalcidol is added promptly, providing a new idea for clinical treatment.