个性化干预在糖耐量异常人群亚临床动脉粥样硬化患者中的应用效果

Intervention effect assessment of people's way of life of atherosclerosis

目的探讨生活方式干预对糖耐量异常人群亚临床动脉粥样硬化的应用效果。方法选取随机对照研究方法,随机选取南方医科大学南方医院2011年4月~2013年4月健康查体且经OCTT试验诊断为糖耐量异常的患者116例,随机分为对照组和实验组,每组各58例,对照组采用普通饮食加运动的生活方式干预,实验组进行强化饮食控制加标准量化运动方案的生活方式干预,观察两组患者干预前、干预后0.5、1、2年空腹血糖、餐后2 h血糖的情况、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、自我管理能力、生活质量、颈动脉内膜厚度（IMT）、颈股脉搏波速度（cf-PWV）等情况。结果干预0.5、1、2年后,实验组的空腹血糖、餐后2 h血糖、TC、TG、HDL-C、LDL-C、IMT、cf-PWV、自我管理能力改善程度明显优于对照组（P〈0.05）;实验组的亚临床动脉粥样硬化发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论强化饮食控制加标准量化运动方案的生活方式干预可有效改善糖耐量异常人群的血糖、血脂水平,提高患者的自我管理能力,有效减少亚临床动脉粥样硬化的发生。

Objective To discuss application effect of lifestyle intervention on abnormal people with a glucose tolerance. Methods 116 cases of patients physically check-uped and diagnosed by OCTT test as abnormal glucose tolerance in Nanfang Hospital of Nanfang Medical University from April 2011 to April 2013 were selected and randomly divided into control group and experimental group, with 58 cases in each group, control group was intrevented with normal diet plus exercise lifestyle, the experimental group was strengthened with diet and lifestyle intervention of standard quantitative movement scheme. Fasting blood-glucose. 2 h postprandial blood glucose, total cholesterol（TC）, triglyceride（TG）, high-density lipoprotein cholesterol（HDL-C）, low density lipoprotein cholesterol（LDL-C） and self management ability, the quality of life, carotid intima thickness（IMT）, carotid pulse wave velocity（cf-PWV） of two groups of patients before intervention, 6 months, 1 year, 2 years after intervention were observed. Results Six months, 1 year,2 years after intervention, fasting blood-glucose 2 h postprandial blood glucose, TC, TG, HDL-C, LDL-C, IMT, cf-PWV and self management ability improvement in experimental group were significantly better that of control group（P 〈0.05）; the incidence of subclinical atherosclerosis in experimental group was significantly lower than that in control group, with statistical significance（P 〈0.05）. Conclusion Strengtheneing the diet control and standard of quantitative sports lifestyle intervention can effectively improve the glucose tolerance abnormal crowd of blood sugar, blood lipid levels, improve the patients＇ self-management ability, and effectively reduce the occurrence of subclinical atherosclerosis.