代谢综合征患者健康管理的干预研究

Effects of Health Management on Patients with Metabolic Syndrome

目的评价对代谢综合征(MS)患者实施健康管理的干预效果。方法入选MS患者137例,随机分为干预组(74例)和对照组(63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。对照组未行健康管理干预。随访12个月,测定随访前后所有患者的腰围(WC)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C),并进行健康知信行评估。结果随访12个月后,干预组WC、SBP、FPG、TG、HDL-C分别为(86.7±6.4)cm、(124.9±9.2)mm Hg、(5.52±0.8)mmol/L、(1.68±0.52)mmol/L、(1.21±0.28)mmol/L,与随访前[(90.6±6.5)cm、(138.1±11.6)mm Hg、(6.04±0.85)mmol/L、(2.15±0.74)mmol/L、(1.15±0.29)mmol/L)]相比,均有统计学意义(P<0.01);但干预组DBP随访前后无统计学意义(P>0.05)。干预组WC、SBP、FPG、TG、HDL-C的达标率分别为35.1%,68.9%,58.1%,64.9%,56.8%,与对照组(12.7%,36.5%,34.9%,49.2%,31.7%)相比,均有提高(P<0.05)。随访后,干预组健康信念持有率、健康知晓率和健康行为执行率分别为74.3%,64.9%,60.8%,与随访前(20.3%,17.5%,18.9%)相比,均有提高(P<0.001),与对照组(30.2%,23.8%,28.6%)相比,也均有提高(P<0.001)。结论对MS患者实施健康管理,加强生活方式的调控,可有效改善MS指标。

Objective To evaluate the effects of health management on patients with metabolic syndrome. Methods 137 cases with metabolic syndrome were randomly assigned to treatment group（n=74） and control group（n=63）. Health management including health education, rational diet, regular exercise and correcting bad life habits was conducted in treatment group, but the control group wasn＇t. Every patients were followed for 12 months, their systolic blood pressnre（SBP）, diastolic blood pressure （DBP）, tfiglyceride （TG）, waist circumference （WC）, fasting blood glucose （FPG） and high density lipoprotein cholesterol （HDL-C） were determined in both groups in both pre- and post-observation. The knowledge, attitude and practice rate about health was also assessed in both groups during the stage of followed up. Results After 12 months of health management, WC, SBP, FPG, TG and HDL-C in treatment group were（86.7±6.4） cm,（124.9±9.2） mm Hg, （5.52±0.8） mmol/L,（1.68±0.52） mmol/L and （1.21±0.28） mmo]/L, which were significantly changed compared to the those before health management （90.6±6.5 cm, 138.1 ±11.6 mmHg, 6.04 ± 0.85mmol/L, 2.15±0.74 mmol/L and 1.15±0.29 mmol/L） （P〈0.01）, but DBP did not have significant change （P〉0.05）. The rates of reaching the standard of WC, SBP, FPG, TG and HDL-C in treatment group were 35.1%, 68.9%, 58.1%, 64.9% and 56.8%, respectively, which were significantly higher than those in the control group （12.7%, 36.5%, 34.9%, 49.2% and 31.7%） （all P〈0.05）. After health management, the rates of knowledge, attitude and practice about health in treatment group（74.3%, 64.9% and 60.8%, respectively） were also significantly higher than those in the control group（30.2%, 23.8%, and 28.6%） （P〈0.01）. Conclusion Health management could raise good life style, decrease risk factors for metabolic syndrome, and be beneficial to early prevention of cardiovascular diseases.