综合干预对代谢综合征患者的疗效及血清脂肪细胞因子水平的影响

Curative effect of comprehensive intervention to patients with metabolic syndrome and its influence on levels of serum adipocytokines

目的观察饮食、运动及药物综合干预对代谢综合征(metabolic syndrome,MS)患者的疗效及其对患者血清瘦素、抵抗素、脂联素水平影响。方法通过体检,纳入深圳市慢性病防治院"慢性病管理数据库"中的56例MS患者,随机分为综合干预组(n=30)及单纯药物干预组(n=26)。综合干预组给予饮食、运动及药物综合干预措施;单纯药物干预组给予药物干预治疗。两组患者分别于干预前、干预3个月、6个月末检测体重指数、血压、血糖、血脂及血清瘦素、抵抗素、脂联素水平,干预3个月、6个月末评价MS患者达标控制率,并对两组指标进行比较分析。结果两组患者干预后BMI、血糖、血脂、血压指标均有改善,但综合干预组改善效果更显著。综合干预组患者干预3个月及6个月后达标控制率分别为83.3%及93.3%,显著高于同时间段单纯药物干预组患者的达标控制率(73.1%及80.8%),并有统计学意义(P<0.05)。单纯药物干预组瘦素、抵抗素、脂联素水平在干预前、及干预3个月、6个月均无统计学差异(P>0.05);综合干预组干预3个月、6个月后瘦素、抵抗素、脂联素水平与干预前水平比较,及干预3个月与6个月时水平比较,差异均具有统计学意义(P<0.05);两组患者在干预6个月后瘦素、抵抗素、脂联素水平比较,也有统计学差异(P<0.05)。结论饮食、运动及药物综合干预措施能有效改善MS患者血清瘦素、抵抗素、脂联素水平,提高MS患者症状的达标控制率。

Objective To observe the curative effects of diet,sport and medicinal comprehensive intervention to the patients with metabolic syndrome（MS） and their influences on the levels of serum leptin,resistin and adiponectin.Methods After physical examination,there were 56 MS patients included into the database of chronic disease management of Shenzhen Center for Chronic Disease Control,and then they were randomly divided into comprehensive intervention group（comprehensive group,n=30） and simple medication intervention group（simple group,n=26）.Comprehensive group was given diet,sport and medicinal comprehensive intervention and simple group,only medication intervention.The indexes of body mass index（BMI）,blood pressure,plasma glucose,blood fat and levels of serum leptin,resistin and adiponectin were detected respectively before intervention and 3 months and 6 months after intervention.The control rate of reaching standard was assessed 3 months and 6 months after intervention and all indexes were compared and analyzed in two groups.Results After intervention,the indexes of BMI,plasma glucose,blood fat and blood pressure were improved in two groups but more significant in comprehensive group.The control rate of reaching standard was 83.3% after 3 months and 93.3% after 6 months in comprehensive group,and they were significantly higher than those in simple group at the same time points（73.1% and 80.8%,P0.05）.The levels of serum leptin,resistin and adiponectin had no statistical difference in simple group before and after intervention（P0.05）,while in comprehensive group,they were different 3 months and 6 months after intervention than those before intervention,and statistically different after 3 months than those after 6 months（P0.05）.Between two groups,the levels of leptin,resistin and adiponectin were statistically different 6 months after intervention（P0.05）.Conclusion Diet,sport and medicinal comprehensive intervention can effectively ameliorate the levels of leptin,resistin and adiponectin and promote the control rate of reaching standard of symptoms in MS patients.