检索历史 清除

目的 探索不同管理模式对糖尿病前期人群生活方式干预效果的影响.方法 采取前瞻性观察研究的方法,将1182名糖尿病前期患者随机分为单独访谈组、集体宣教组、通讯访谈组3个干预组和1个对照组,对干预组进行健康教育与指标控制相结合的为期2年的生活方式干预,多组比较采用方差分析或X2检验,组间的两两比较采用q检验.结果 干预组空腹血糖、餐后2小时血糖均呈下降趋势(P＜0.05).三个干预组之间的两两比较,干预6个月以后单独访谈组、集体宣教组的空腹血糖均值明显低于通讯访谈组,干预24个月以后单独访谈组的空腹血糖均值开始低于集体宣教组(P＜0.05).干预组转为理想血糖的百分比远远高于对照组,同时发展为糖尿病的百分比远远低于对照组.接受不同干预方案后与对照组相比,3个干预组的血压、三酰甘油、胆固醇、肌酐等指标有显著性改善,肥胖的发生率也显著下降(P＜0.05)；心电图、动脉硬化程度则无明显变化(P＞0.05).3种不同管理模式的干预效果比较,单独访谈组和集体宣教组均明显优于通讯访谈组,但单独访谈组的依从性最差.结论 对糖尿病前期患者实施健康教育与指标控制相结合的生活方式干预,能预防或延缓糖尿病的发生.综合评价3种不同管理模式,医院体检中心与体检客户联手的集体宣教是较佳的干预管理模式.

Objective To explore the effects of different health management on adults with prediabetes.Methods A total of 1182 pre-diabetics were enrolled in this prospective observation study and assigned to one-by-one interview group,in situ education group,communicative interview group and control group.Three intervention groups received life style intervention ( including health education and risk factor control) for 2 years.Analysis of variance,x2 test or q test were used for data analysis.Results After year intervention,fasting plasma glucose (FPG) and 2 h plasma glucose of the intervention groups were significantly decreased ( P ＜ 0.05 ).FPG of the one-by-one interview group and the in situ education group was significantly lower than that of the communicative interview group at 6 months ( P ＜ 0.05 ). At 24months,FPG of the one-by-one interview group was lower than that of the in situ education group (P ＜0.05).The percentage of participants who showed appropriate blood glucose control was increased in the intervention groups. In addition,blood pressure,triglyceride,cholesterol,creatinine and body weight of those in the intervened groups were significantly improved compared with the control group ( all P ＜ 0.05 ),although electrocardiogram results and arteriosclerosis showed no significant changes (P ＞ 0.05 ).Conclusion Health management may contribute to life style change and hypertension control of prediabetics.Furthermore,in situ education may be the most effective life style interventions.