生活方式和心理干预对新诊断代谢综合征患者效果评价

Evaluation of life style and psychological intervention in newly-diagnosed patients with metabolic syndrome

目的:探讨生活方式干预和心理干预对新诊断代谢综合征患者的干预效果,为代谢综合征及其相关慢性病的科学防治提供依据。方法:采用整群随机对照试验的方法,将183例新诊断代谢综合征患者分为生活方式干预组(92人)、综合干预组(46人)及对照组45人,干预组进行为期1年干预,对照组除慢性病常规管理外未施加其它任何干预,比较干预前后腰围(WC)、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、胆固醇酯(TC)、高密度脂蛋白(HDL-C)、空腹血糖(FPG)等指标的变化。结果:与干预前相比,生活方式干预组干预后WC、BMI、TG水平降低,综合干预组WC、BMI、DBP、TC水平降低,HDL-C水平升高,对照组HDL-C水平降低、FPG水平升高,差异有统计学意义(P<0.01),对照组其余指标干预前后差异无统计学意义(P<0.05);生活方式干预组及综合干预组与对照组比较,调整后WC、BMI和HDL-C水平差异有统计学意义(P<0.05),综合干预组调整后HDL-C高于生活方式干预组(P<0.01)。结论:干预一年后,生活方式干预及综合干预措施均能有效改善新诊断代谢综合征患者的WC、BMI和HDL-C水平,缓解代谢综合征症状,均为有效的干预措施,但综合干预组与生活方式干预组相比,干预效果并未发现明显优势。

Objective To investigate the lifestyle and comprehensive intervention effects on the newly-diagnosed metabolic syndrome patients.Methods A cluster-randomized controlled trial was performed,183newly-diagnosed metabolic syndrome patients were assigned into lifestyle intervention group（92cases）,comprehensive intervention group（46cases）and control group（45cases）.Waist circumference（WC）,body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,triglyceride（TG）,total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）and fasting plasma glucose（FPG）were detected respectively before intervention and after one-year intervention.Results After intervention,the levels of WC,BMI,and TG of lifestyle intervention group and the levels of WC,BMI,DBP,TC of comprehensive intervention group were significantly decreased;the HDL-C level of comprehensive intervention group was significantly increased;the HDL-C level decreased and FPG level increased in control group.The differences were significant among three groups（P〈0.01）.There were no significant differences in other indexes in control group before and after the intervention（P〈0.05）.Compared with control group,the adjusted level of WC,BMI and HDL-C of lifestyle intervention group and comprehensive intervention group were significantly improved（P〈0.05）,and the HDL-C level in comprehensive intervention group was significantly higher than that in lifestyle intervention group（P〈0.01）.Conclusions Both in lifestyle intervention group and comprehensive intervention group,intervention measures can effectively improve the WC,BMI and HDL-C levels of newly-diagnosed metabolic syndrome patients,yet there is no significant evidence to prove that comprehensive interventions have obvious advantages over lifestyle interventions.