综合干预对改善肥胖学生代谢指标效果分析

Effect analysis on comprehensive intervention for improving metabolic indices of obese student

目的了解"儿童肥胖早期干预方案及应用研究"课题实施对改善肥胖中学生营养状况和代谢指标的效果,为政府出台相应政策措施提供依据。方法采用现场实验研究的方法,从北京市西城区、海淀区选择4所初中和4所高中的初一、高一年级全体肥胖学生作为目标人群,并设立干预组、对照组,开展为期1 a的疾控—学校—临床—家庭一体化的干预试点研究。通过基线、终期健康体检和学生生化指标监测,比较干预组和对照组肥胖学生营养状况和代谢指标的变化。结果项目实施1 a后,干预组273名肥胖学生中有31.14%转为超重或正常,对照组317名肥胖学生中占25.47%转为超重或正常。干预组肥胖学生的体质量指数、体脂成分体脂含量(FMP)、血压、血脂等其他各项指标干预前后差异均无统计学意义,谷草转氨酶(AST)明显下降(t=2.91,P<0.01);对照组肥胖学生体质指数、低密度脂蛋白(LDL-C)、谷丙转氨酶(ALT)均明显增高(t值分别为1.99,2.19,1.92,P值均<0.05),空腹血糖和低密度脂蛋白(LDL-C)增高的幅度也高于干预组(t值分别为2.29,2.19,P值均<0.05)。结论疾控—学校—临床—家庭一体化的干预模式对改善肥胖学生代谢疾病相关指标的效果优于单纯健康教育模式,建立以学生为主体,家庭、学校、专业机构共同参与的健康管理与疾病防控机制,应作为今后学校卫生防病工作的推进方向。

Objective To analyze the effect of implementing the project research on early intervention program and application for childhood obesity on improving the nutritional status and metabolic indices of obese middle school student,and to provide scientific basis for government to enact corresponding policies and measures.Methods Field experiment was used to choose four junior high schools and four senior high schools from two districts,all first grade and senior grade one obese students were target population.Intervention group and control group were set up to carry out for a period of 1 year disease control and prevention-schoolclinical-integration of family intervention pilot study,through the baseline and final stage of physical examination and biochemical indicators monitoring survey,the change of the intervention group and the control group nutritional and metabolism indexes was compared,the efficacy of the intervention was evaluated.Result Approximately 31.14% of 273 obesity students of the intervention group turned into overweight or normal.25.47% of 317 students of the control group turned into overweight or normal.The BMI,FMP,blood pressure,blood fat and other indexes of the intervention group students didn’t rise any more,and the AST obviously declined;the BMI,LDL-C,and ALT of the control group students obviously rised,the amount of increase of the fasting blood-glucose and LDL-C was obviously higher than the intervention group.Conclusion This disease control and prevention-school-clinicalintegration of family intervention model is better than that of simple health education model on improving obese students the effect of metabolic diseases related indicators.Therefore,health management and disease prevention and control mechanism in which family,school,professional organizations all take part and students act as the main body should be set up,and it should be development direction of school health prevention work in the future.