中华健康管理学杂志
中華健康管理學雜誌
중화건강관이학잡지
CHINESE JOURNAL OF HEALTH MANAGEMENT
2012年
1期
45-49
,共5页
陆昀%沈振海%李红卫%冯银波%王凌%江钟立
陸昀%瀋振海%李紅衛%馮銀波%王凌%江鐘立
륙윤%침진해%리홍위%풍은파%왕릉%강종립
代谢综合征X%干预性研究%动脉粥样硬化%胰岛素抵抗
代謝綜閤徵X%榦預性研究%動脈粥樣硬化%胰島素牴抗
대사종합정X%간예성연구%동맥죽양경화%이도소저항
Metabolic syndrome X%Intervetion studies%Atherosclerosis%Insulin resistance
目的 探讨生活方式干预对非糖尿病代谢综合征(MS)患者动脉血管早期病变检测指标的影响.方法 入选非糖尿病MS患者87例,随机分为干预组(47例)和对照组(40例).干预组实施健康管理,包括健康教育、合理膳食、规律运动、纠正不良习惯等生活方式干预.对照组未行健康管理干预.随访9个月,所有患者随访前后均进行体重指数(BMI)、腰围(WC)、收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、高敏C反应蛋白(hs-CRP)、颈动脉内膜中层厚度(IMT)、臂踝脉搏波速度(baPWV)、踝臂指数(ABI)的测定.结果 (1)干预组BMI、WC、SBP、TG、HDL-C、FPG、HbA1c、FINS、HOMA-IR和hs-CRP在干预后6个月、9个月与干预前相比均显著改善,差异有统计学意义(P＜0.05),并且HDL-C、FPG、HbA1c、FINS、HOMA-IR和hs-CRP在干预后9个月与干预后6个月相比又进一步改善,差异有统计学意义(P＜0.05).与对照组相比,干预后9个月干预组BMI、WC、HDL-C、FPG、HbA1c、FINS、HOMA-IR和hs-CRP有改善,差异有统计学意义(P＜0.05).(2)干预组baPWV和ABI在干预后6个月、干预后9个月与干预前相比有改善,差异有统计学意义(F值分别为:32.98,45.81；P ＜0.05).与对照组相比,干预后9个月干预组baPWV和ABI有改善,差异有统计学意义(t值分别为:-5.62,5.99；P＜0.05).(3)干预组baPWV在干预后9个月的异常率为44.68％,与干预前(68.09％)相比有改善,差异有统计学意义(x2 =5.23,P ＜0.05).(4)baPWV与hs-CRP、HOMA-IR相关(OR值分别为:0.436,0.565)；ABI与hs-CRP、HOMA-IR相关(OR值分别为:0.543,0.502).结论 对MS患者实施健康管理,加强生活方式的调控,能明显改善非糖尿病MS患者的胰岛素抵抗,调节糖脂代谢,减轻炎症反应,并在一定程度上能延缓动脉粥样硬化的进程.
目的 探討生活方式榦預對非糖尿病代謝綜閤徵(MS)患者動脈血管早期病變檢測指標的影響.方法 入選非糖尿病MS患者87例,隨機分為榦預組(47例)和對照組(40例).榦預組實施健康管理,包括健康教育、閤理膳食、規律運動、糾正不良習慣等生活方式榦預.對照組未行健康管理榦預.隨訪9箇月,所有患者隨訪前後均進行體重指數(BMI)、腰圍(WC)、收縮壓(SBP)、舒張壓(DBP)、三酰甘油(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、空腹血糖(FPG)、糖化血紅蛋白(HbA1c)、空腹胰島素(FINS)、胰島素牴抗指數(HOMA-IR)、高敏C反應蛋白(hs-CRP)、頸動脈內膜中層厚度(IMT)、臂踝脈搏波速度(baPWV)、踝臂指數(ABI)的測定.結果 (1)榦預組BMI、WC、SBP、TG、HDL-C、FPG、HbA1c、FINS、HOMA-IR和hs-CRP在榦預後6箇月、9箇月與榦預前相比均顯著改善,差異有統計學意義(P＜0.05),併且HDL-C、FPG、HbA1c、FINS、HOMA-IR和hs-CRP在榦預後9箇月與榦預後6箇月相比又進一步改善,差異有統計學意義(P＜0.05).與對照組相比,榦預後9箇月榦預組BMI、WC、HDL-C、FPG、HbA1c、FINS、HOMA-IR和hs-CRP有改善,差異有統計學意義(P＜0.05).(2)榦預組baPWV和ABI在榦預後6箇月、榦預後9箇月與榦預前相比有改善,差異有統計學意義(F值分彆為:32.98,45.81；P ＜0.05).與對照組相比,榦預後9箇月榦預組baPWV和ABI有改善,差異有統計學意義(t值分彆為:-5.62,5.99；P＜0.05).(3)榦預組baPWV在榦預後9箇月的異常率為44.68％,與榦預前(68.09％)相比有改善,差異有統計學意義(x2 =5.23,P ＜0.05).(4)baPWV與hs-CRP、HOMA-IR相關(OR值分彆為:0.436,0.565)；ABI與hs-CRP、HOMA-IR相關(OR值分彆為:0.543,0.502).結論 對MS患者實施健康管理,加彊生活方式的調控,能明顯改善非糖尿病MS患者的胰島素牴抗,調節糖脂代謝,減輕炎癥反應,併在一定程度上能延緩動脈粥樣硬化的進程.
목적 탐토생활방식간예대비당뇨병대사종합정(MS)환자동맥혈관조기병변검측지표적영향.방법 입선비당뇨병MS환자87례,수궤분위간예조(47례)화대조조(40례).간예조실시건강관리,포괄건강교육、합리선식、규률운동、규정불량습관등생활방식간예.대조조미행건강관리간예.수방9개월,소유환자수방전후균진행체중지수(BMI)、요위(WC)、수축압(SBP)、서장압(DBP)、삼선감유(TG)、총담고순(TC)、고밀도지단백담고순(HDL-C)、저밀도지단백담고순(LDL-C)、공복혈당(FPG)、당화혈홍단백(HbA1c)、공복이도소(FINS)、이도소저항지수(HOMA-IR)、고민C반응단백(hs-CRP)、경동맥내막중층후도(IMT)、비과맥박파속도(baPWV)、과비지수(ABI)적측정.결과 (1)간예조BMI、WC、SBP、TG、HDL-C、FPG、HbA1c、FINS、HOMA-IR화hs-CRP재간예후6개월、9개월여간예전상비균현저개선,차이유통계학의의(P＜0.05),병차HDL-C、FPG、HbA1c、FINS、HOMA-IR화hs-CRP재간예후9개월여간예후6개월상비우진일보개선,차이유통계학의의(P＜0.05).여대조조상비,간예후9개월간예조BMI、WC、HDL-C、FPG、HbA1c、FINS、HOMA-IR화hs-CRP유개선,차이유통계학의의(P＜0.05).(2)간예조baPWV화ABI재간예후6개월、간예후9개월여간예전상비유개선,차이유통계학의의(F치분별위:32.98,45.81；P ＜0.05).여대조조상비,간예후9개월간예조baPWV화ABI유개선,차이유통계학의의(t치분별위:-5.62,5.99；P＜0.05).(3)간예조baPWV재간예후9개월적이상솔위44.68％,여간예전(68.09％)상비유개선,차이유통계학의의(x2 =5.23,P ＜0.05).(4)baPWV여hs-CRP、HOMA-IR상관(OR치분별위:0.436,0.565)；ABI여hs-CRP、HOMA-IR상관(OR치분별위:0.543,0.502).결론 대MS환자실시건강관리,가강생활방식적조공,능명현개선비당뇨병MS환자적이도소저항,조절당지대사,감경염증반응,병재일정정도상능연완동맥죽양경화적진정.
Objective To explore the effects of lifestyle intervention on index of early artery diseases in nondiabetic patients with metabolic syndrome (MS). Methods Eighty-seven nondiabetic patients with MS were randomly assigned to the intervention group ( n =47) and the control group ( n =40).The patients in the intervention group received health education,diet control,regular physical exercises,and unhealthy habit correction; however,the control group did not receive any intervention.All the patients were followed up for 9 months.Body mass index (BMI),waist circumference (WC),systolic blood pressure (SBP),diastolic blood pressure (DBP),triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol ( HDL-C ),low-density lipoprotein cholesterol ( LDL-C ),fasting blood glucose (FBG),HbAlc,fasting insulin (FINS),HOMA-IR,high sensitivity C-reactive protein (hs-CRP),carotid intima-media thickness (IMT),brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index(ABI) were measured at baseline and at 9 months.Results After 6 or 9 months' intervention,BMI,WC,SBP,TG,HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were improved (all P ＜ 0.05). HDL-C,FPG,HbAlc,FINS,HOMA-IR and hs-CRP of the intervention group were further improved at 9 months when compared to 6 months ( all P ＜ 0.05 ). In comparison with the control group,BMI,WC,HDL-C,FPG,HbA1 c,FINS,HOMA-IR and hs-CRP were significantly improved in the intervention group at 9 months ( all P ＜ 0.05 ).After 6 or 9 months' intervention,baPWV and ABI were significantly changed ( both P ＜ 0.05 ) in the intervention group although IMT of the carotid did not changed (P ＞0.05). BaPWV and ABI were significantly changed in the intervention group when compared with those in the control group at 9 months ( both P ＜ 0.05).The abnormal rate of baPWV in the intervention group at 9 months was 44.68％. BaPWV and ABI were associated with hs-CRP and HOMA-IR.Conclusions In nondiabetic MS patients, health management could significantly improve insulin resistance,modify metabolic disorders,and prevent the development of atherosclerosis.
