CAJ | 학술논문

目的：探讨改变代谢综合征患者心脑血管事件发病率的强化干预措施，并比较分析干预效果。方法以2011年5月至8月在我院体检中心进行健康体检的三水区事业单位职工3480例作为研究对象，强化干预组共1740例，其中MS组286例，非MS组1454例；对照组共1740例，其中MS组305例，非MS组1435例。对照组接受自主常规的临床治疗；强化干预组接受常规治疗的同时，根据患者是否患有代谢综合征及其相关疾病、疾病前状态（包括高血压、肥胖、超重、糖尿病、糖耐量减退、血脂异常）等分别采取不同的强化治疗方案进行干预。分别统计两组患者在治疗前后体质量指数、血压、血脂、空腹血糖等指标变化和心脑血管事件发生情况。结果强化干预组MS亚组患者治疗后血压下降（9.53±2.43）mm Hg（1 mm Hg=0.133 kPa），空腹血糖为（6.26±1.17）mmol/L，对照组MS亚组患者分别为（5.61±2.65）mm Hg和（6.89±1.19）mmol/L，强化干预组改善效果明显优于对照组，具有统计学意义（P＜0.05）。强化干预组中， MS亚组患者的冠心病事件和脑卒中事件的发生数分别为28例和26例，而非MS亚组患者的冠心病事件和脑卒中事件的发生数分别为99例和91例；对照组中，MS亚组患者的冠心病事件和脑卒中事件的发生率分别为40例和41例，而非MS亚组患者的冠心病事件和脑卒中事件的发生率分别为172例和174例。强化干预组MS亚组心脑血管事件的发生例数，明显低于对照组MS亚组患者的发生例数，强化干预组非MS亚组的患者例数明显低于对照组非MS亚组的患者例数，组间对比均具有统计学意义（P＜0.05）。结论强化干预手段联合治疗代谢综合征患者，可以有效降低心脑血管事件的发病率，值得临床积极推广。
목적：탐토개변대사종합정환자심뇌혈관사건발병솔적강화간예조시，병비교분석간예효과。방법이2011년5월지8월재아원체검중심진행건강체검적삼수구사업단위직공3480례작위연구대상，강화간예조공1740례，기중MS조286례，비MS조1454례；대조조공1740례，기중MS조305례，비MS조1435례。대조조접수자주상규적림상치료；강화간예조접수상규치료적동시，근거환자시부환유대사종합정급기상관질병、질병전상태（포괄고혈압、비반、초중、당뇨병、당내량감퇴、혈지이상）등분별채취불동적강화치료방안진행간예。분별통계량조환자재치료전후체질량지수、혈압、혈지、공복혈당등지표변화화심뇌혈관사건발생정황。결과강화간예조MS아조환자치료후혈압하강（9.53±2.43）mm Hg（1 mm Hg=0.133 kPa），공복혈당위（6.26±1.17）mmol/L，대조조MS아조환자분별위（5.61±2.65）mm Hg화（6.89±1.19）mmol/L，강화간예조개선효과명현우우대조조，구유통계학의의（P＜0.05）。강화간예조중， MS아조환자적관심병사건화뇌졸중사건적발생수분별위28례화26례，이비MS아조환자적관심병사건화뇌졸중사건적발생수분별위99례화91례；대조조중，MS아조환자적관심병사건화뇌졸중사건적발생솔분별위40례화41례，이비MS아조환자적관심병사건화뇌졸중사건적발생솔분별위172례화174례。강화간예조MS아조심뇌혈관사건적발생례수，명현저우대조조MS아조환자적발생례수，강화간예조비MS아조적환자례수명현저우대조조비MS아조적환자례수，조간대비균구유통계학의의（P＜0.05）。결론강화간예수단연합치료대사종합정환자，가이유효강저심뇌혈관사건적발병솔，치득림상적겁추엄。
Objective To investigate the metabolic changes of comprehensive strengthen intervention measures in patients with cardiovascular and cerebrovascular morbidity, and comparative analysis of intervention effect.Methods Sanshui District institution staff to 2011 from May to August in our hospital medical center for health examination in 3480 cases as the research object, the intervention group were 1740 cases, including 286 cases of MS group, non MS group 1454 cases; the control group of 1740 cases, including 305 cases of MS group, non MS group of 1435 cases. The control group received conventional treatment independently; the intervention group received conventional treatment at the same time, according to whether patients with metabolic syndrome and its related diseases, disease state(including hypertension, obesity, overweight, diabetes, impaired glucose tolerance, dyslipidemia) divided different strengthening intervention. Compared between the two groups before and after treatment in patients with body mass index, blood pressure, blood lipid, fasting blood glucose and other indicators of changes in cardiac and cerebrovascular events.Results Strengthening intervention group MS sub group patients after blood pressure decreased by(9.53±2.43)mm Hg, fasting blood sugar was(6.26±1.17)mmol/L, control group MS subgroups of patients were (5.61±2.65)mmHg and(6.89±1.19)mmol/L, the intervention group improved significantly better than the control group, with statistical significance(P<0.05). The intervention group, MS subgroups of patients with coronary heart disease and stroke were 28 cases and 26 cases, and non MS subgroups of patients with CHD events and stroke events were 99 cases and 91 cases; control group, the incidence of MS subgroups of patients with CHD events and stroke events there were 40 cases and 41 cases, rather than the incidence of MS subgroups of patients with CHD events and stroke events were 172 cases and 174 cases. Strengthening of the intervention group subgroup MS of cardiovascular events was significantly lower than that in control group, MS subgroup of patients of intervention group, the number of patients with non MS group was significantly lower than the control group the number of patients with non MS subgroups, the comparison between the two groups were statistically significant(P<0.05).Conclusion To strengthen the intervention therapy in patients with the metabolic syndrome, can effectively reduce the incidence of cardiovascular event rate, is worth the clinical promoted.