代谢综合征周围动脉硬化特征及对其综合干预的影响

Effects of comprehensive intervention in peripheral arteriosclerotic occlusive disease of patients with metabolic syndrome

目的探讨综合干预对代谢综合征(MS)患者周围动脉硬化症的影响.方法收集2002～2005年就诊的患者352例,MS组252例、高血压病(EH组)49例和2型糖尿病(T2DM组)51例,将接受综合干预的199例患者作为干预组,尚未综合干预的153例患者作为对照组,测量腹围(WC)、体重指数(BMI)、血压(BP)、血糖、血脂等指标,比较两组踝肱指数(ABPI)的变化情况.结果周围动脉狭窄的患者空腹血糖(FPG)、甘油三酯(TG)、WC、SBP较正常组显著增高,周围动脉钙化的患者FPG、TG、BMI、WC和DBP水平较正常组显著增高;综合干预组的患者BMI、低密度脂蛋白胆固醇(LDL-C)、DBP和FPG水平较对照组明显降低,而高密度脂蛋白胆固醇(HDL-C)明显增高;干预组周围动脉硬化发生率较对照组明显降低(P<0.05 );周围动脉硬化患者中吸烟率明显高于未发生周围动脉硬化者,而规律运动者的比例明显低于未发生周围动脉硬化者(P<0.05).结论生活方式改善和药物的综合干预,能有效控制MS的部分组分,降低周围动脉硬化症的风险.

Objective To evaluate the effects of comprehensive intervention in peripheral arteriosclerotic occlusive disease （PAOD） of patients with metabolic syndrome. Methods 352 patients were enrolled in this study, who were admitted to hospital with the initial diagnosis of type 2 diabetes mellitus （T2DM, 51 cases）, essential hypertension （EH, 49 cases）, or metabolic syndrome （MS, 252 cases）. Among them 199 patients were comprehensively intervened and the other 153 were not to serve as controls. The abdominal circumference, BMI, blood pressure, blood sugar and plasma lipid were measured and the effects of intervention were evaluated. Results Patients with stenosis of peripheral arteries had higher FPG, TG, WC and SBP levels, and the patients of arteriosteogenesis had higher FPG, TG, BMI, WC and DBP levels. Compared with the control group, the levels of BMI, LDL-C, DBP, and FPG, as well as the incidence of arteriosclerosis obviously declined in the intervention group （P〈0. 05）, while that of HDL-C elevated. Comparing between the smokers and nonsmokers, the incidence of arteriosclerosis was markedly higher in the former than in the latter. However, when comparison was done between the persons with and without regular exercises, it was found that the incidence of arteriosclerosis was significantly lower in the former than in the latter. Conclusions Most of MS components were obviously improved by the comprehensive intervention regimen, and the risk of arteriosclerosis could be decreased.