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目的 通过对武汉市某单位职工代谢综合征的健康管理效果观察,对比分析健康管理对于相关危险因素的发生率及代谢综合征相关指标的影响.方法 将2008年某单位体检中诊断为代谢综合征430例患者,通过问卷调查收集的健康信息进行健康风险因素分析;通过随机分组将207例自愿参与健康管理者作为管理组,管理组给予系统化的健康管理,其余223例作为对照组,仅给予一般性的健康指导及建议,一年后通过再次体检及问卷调查结果对比分析饮食、吸烟、饮酒、熬夜、情绪等危险因素的控制情况及在体重指数(BMI)、血压、血脂包括三酰甘油(TG)、高密度胆固醇(HDL),空腹血糖(FBG)相关指标的变化.结果 通过1年时间的健康管理,在相关危险因素的控制方面:管理组在过咸、高脂、嗜食甜食,饮食量过多、运动量缺少、熬夜、饮酒过量等方面的发生率较管理前减少,差异具有统计学意义(P＜0.05),与对照组相比较,在高脂、嗜食甜食、运动量缺少、熬夜、饮酒过量等方面的比率明显减少,差异具有统计学意义(P＜0.05).而在代谢综合征相关指标方面,管理组在BMI(t=11.10),收缩压(t=25.55)、TG(t=10.55)、FBG(t=20.33)等方面均有明显降低,差异有统计学意义(P＜0.05);与对照组相比较,在BMI(t=9.03),收缩压(t=3.46)、舒张压(t=3.93)、TG(t=10.42)、FBG(t=5.23)的改善差异均具有统计学意义(P＜0.05),结论对于代谢综合征的防治,在相关危险因素的控制方面,仅仅给予一般性的指导建议是不够的,只有通过系统化、个性化的健康管理才能取得良好的依从性,最终有利于代谢综合征的治疗.

Objective To analyze the effects of health management of metabolic syndrome on the control of related risk factors. Methods A total of 430 patients diagnosed with metabolic syndrome in 2008completed questionnaire and before randomly assigned to the health management group ( n = 207 ) and the control group (n=223). One year later, all the participants were investigated for the risk factors of food intake, cigarette smoking, alcohol consumption, staying-up and emotion, and the changes of body mass index ( BMI), blood pressure ( BP), triglyceride (TG), high-density lipoprotein cholesterol (HDL) and fasting blood glucose (FBG). Student's t test and x2 test were used for data analysis. Results For the health management group, the incidence of high-salt, high-fat and high-sugar intake, overtake of food, lack of physical exercises,staying-up and alcohol drinking was significantly decreased at 1 year (P ＜ 0. 05 ), when compared with baseline and the control group ( both P ＜ 0. 05 ). For the health management group, BMI,systolic blood pressure (SBP),TG and FBG was improved at 1 year (P＜0. 05). In comparison with the control group, BMI, SBP, diastolic blood pressure (DBP),TG and FBG of the management group were significantly improved (P ＜ 0. 05 ). Conclusions Patients with metabolic syndrome may have better treatment compliance after receiving systematized and individualized health management.