非酒精性脂肪肝大学生“互联网+”健康管理干预效果分析

Effect of internet-based health management intervention among college students with nonalcoholic fatty liver disease

目的探讨"互联网+"健康管理在非酒精性脂肪肝大学生患者中的应用效果。方法 2014年9-11月选取2014级入学体检的非酒精性脂肪肝患者120例,进行随机分组各60例,干预组通过"互联网+"健康管理的线上线下结合干预方式通过网络平台如微博、QQ群、微信等方式给予患者专业的管理和指导,并联合"健康促进志愿者"线下对患者开展运动和饮食指导,1年后统计患者的健康行为和身体状况。结果干预1年后,"互联网+"健康管理组31例NAFLD患者肝脏B超检查干预有效,而对照组仅13例干预有效,干预组患者B超检查治疗效果优于对照组,差异有统计学意义(χ~2=11.63,P=0.000);在体质指数及血脂检测各项结果表明,两组患者干预1年后BMI、TG、TC、LDL-C各观察指标较干预前均降低,而传统健康管理模式差异无统计学意义(P>0.05);"互联网+"健康管理模式差异均有统计学意义(TBMI=2.845,TTG=2.145,TTC=2.960,TLDL-C=2.107,且均P<0.05),仅HLD-C变化上差异不明显(THDL-C=1.857,P>0.05)。在健康行为方面,传统健康管理模式只对患者的饮食习惯有改善,且具有统计学差异(χ~2=4.09,P<0.05),而在运动及生活方面变化不大;而经过"互联网+"健康管理模式干预后患者在运动、饮食和生活方式三方面均有变化(χ_(运动)~2=38.58,χ_(饮食)~2=56.05,χ_(生活)~2=49.69,均P<0.05);结论通过线上线下结合的"互联网+"健康管理的干预措施能够帮助患者养成良好的健康行为,改善患者的脂肪肝病情。

Objective To explore the effect of an internet-based health management intervention among college students with nonalcoholic fatty liver disease （NAFLD）.Methods Totally 120 colleges students identified with NAFLD at entrance physical examination were recruited in 2014 and randomly divided into an intervention group （60） receiving professional management and guidance on physical exercise and dietary pattern via micro-blog,QQ groups and wechat combined with conventional interventions conducted by health promotion volunteers and a control group （60） only receiving routine health management service for college students.One year after the intervention,health status and behavior of the participants were surveyed and compared between the two groups.Results One year after the intervention,the number of participants with improved signs of NAFLD in B ultrasound examination was significantly greater than that of the control group （31 vs.13, χ2=11.63;P=0.000）.The body mass index （BMI）,triglyceride （TG）,total cholesterol （TC）,low density lipoprotein cholesterol （LDL-C） were all lower significantly than those before the intervention for the participants of the intervention group （tBMI=2.845,tTG=2.145,tTC=2.960,tLDL-C=2.107;P〈0.05 for all）,except for high density lipoprotein cholesterol（HDL-C）（t=1.857,P〉0.05）;but no significant variations in the indicators were observed though all the indexes were decreased among the participants of control group （P〉0.05）.Significant changes in physical exercise,dietary behavior,and life style were observed among the participants of intervention group （χphysical exercise2=38.58,χdietary behavior2=56.05, χlife style2=49.69;P〈0.05 for all）;whereas a significant change in dietary behavior was observed among the participants of control group （χ2=4.09,P〈0.05）.Conclusion The internet-based health management intervention combined with offline conventional interventions could help college students with NAFLD in adopting health behaviors and alleviating the condition.