摘要
目的探讨综合干预对社区老年代谢综合征(MS)患者血尿酸(SUA)、超敏C反应蛋白(hs-CRP)及脑钠肽(BNP)水平的影响。方法 2016年7月,将苏州市汾湖高新区20个行政村、4个社区逐一编号,随机抽取其中10个行政村、2个社区的老年MS患者291例作为干预组,另外10个行政村、2个社区的老年MS患者272例作为对照组。对照组患者给予常规诊疗及健康知识教育,干预组患者给予以健康教育、治疗性生活方式改变(TLC)、药物干预、自我监测为主的综合干预。两组患者均随访12个月,比较两组患者干预前及干预6个月、12个月空腹血糖(FPG)、血脂指标、体格指数、血压、SUA、hs-CRP、BNP,干预6个月、12个月治疗达标率及转变为非MS者所占比例。结果随访12个月,对照组患者失访、死亡6例,干预组患者失访、死亡5例。干预前两组患者FPG、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、腰围(WC)、腰臀比(WHR)、体质指数(BMI)、收缩压(SBP)、舒张压(DBP)比较,差异无统计学意义(P>0.05);干预6个月、12个月干预组患者FPG、TG、TC、LDL-C、WHR、BMI、SBP、DBP低于对照组,HDL-C高于对照组,WC小于对照组(P<0.05)。干预组患者干预6个月、12个月治疗达标率及转变为非MS者所占比例高于对照组(P<0.05)。干预前两组患者SUA、hs-CRP、BNP水平比较,差异无统计学意义(P>0.05);干预6个月、12个月干预组患者SUA、hs-CRP、BNP水平低于对照组(P<0.05)。结论综合干预能有效控制社区老年MS患者血糖、血压,减轻体质量,纠正脂代谢异常,降低SUA、hs-CRP、BNP水平。
Objective To investigate the impact of comprehensive intervention on SUA,hs-CRP and BNP in elderly patients with metabolic syndrome in community. Methods In July 2016,20 administrative villages and 4 communities were enrolled in Fenhu New High-tech District in Suzhou,291 elderly patients with metabolic syndrome were randomly selected as intervention group from 10 administrative villages and 2 communities,and 272 elderly patients with metabolic syndrome were randomly selected as control group from the other 10 administrative villages and 2 communities. Patients in control group received routine diagnosis,treatment and health knowledge education,while patients in intervention group received comprehensive intervention mainly including health education,therapeutic lifestyle change（TLC）,pharmacological intervention and self-surveillance. Patients in the two groups were followed up for 12 months,FPG,blood lipids index,physical index,blood pressure,SUA,hs-CRP and BNP before intervention,6 months and 12 months after intervention,good control rate of treatment and fade rate of metabolic syndrome 6 months and 12 months after intervention were compared between the two groups. Results During the 12-month follow-up,6 cases in control group and 5 cases in intervention group lost or died. No statistically significant differences of FPG,TG,TC,LDL-C,HDL-C,WC,WHR,BMI,SBP or DBP was found between the two groups before intervention（P〉0.05）;FPG,TG,TC,LDL-C,WHR,BMI,SBP and DBP in intervention group were statistically significantly lower than those in control group 6 months and 12 months after intervention,and HDL-C in intervention group were statistically significantly higher than that in control group,and WC in intervention group was statistically significantly less than that in control group,respectively（P〈0.05）. Good control rate of treatment and fade rate of metabolic syndrome in intervention group were statistically significantly higher than those in control group 6 months and 12 months after intervention（P〈0.05）. No statistically significant differences of SUA,hs-CRP or BNP was found between the two groups before intervention（P〉0.05）,while SUA,hs-CRP and BNP in intervention group were statistically significantly lower than those in control group 6 months and 12 months after intervention（P〈0.05）. Conclusion In elderly patients with metabolic syndrome in community,comprehensive intervention can effectively control the blood glucose and blood pressure,reduce the body mass,SUA,hs-CRP and BNP,correct the lipid metabolism abnormality.
作者
翁根龙
陆建林
吴霞
WENG Gen-long;LU Jian-lin;WU Xia(Department of Cardiology,the First People＇s Hospital of Wujiang District,Suzhou,Suzhou 215200,China;Department of Gerontology,the Fifth People＇s Hospital of Wujiang District,Suzhou,Suzhou 215211,China;Department of Endocrinology,the Fifth People＇s Hospital of Wujiang District,Suzhou,Suzhou 215211,China)
出处
《实用心脑肺血管病杂志》
2018年第4期92-96,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
代谢综合征
老年人
综合干预
治疗结果
尿酸
超敏C反应蛋白
利钠肽
脑
Metabolic syndrome
Aged
Comprehensive intervention
Treatment outcome
Uric acid
Hypersensitive C-reactive protein Natriuretic peptide brain
