强化干预代谢综合征改变心脑血管事件发生风险的纵向随访研究 社区人群心脑血管事件前瞻性研究系列之四  

Longitudinal follow-up study of changing the risk to cardiovascular events by strengthen intervention of community groups in Nanning city

作　　者：吕泽平[1] 黄慧[1] 杨泽[2] 李宁[3] 胡才友[1] 杜治琴[3] 吴军[3] 万钢[2] 刘红[4] 邓宏明[4] 袁晓红[3] 余其美[5] 朱其秀[5] 李绍刚[6] 吕渊[1] 李必迅[1] 庞国防[1] 

机构地区：[1]广西壮族自治区江滨医院,530021 [2]卫生部北京医院,卫生部老年医学研究所,100730 [3]卫生部保健局,100044 [4]广西医科大学第一附属医院,530021 [5]广西大学医院,530004 [6]广西财经学院医院,537500

出　　处：《中国老年保健医学》2009年第1期18-21,共4页Chinese Journal of Geriatric Care

基　　金：广西科技攻关项目(桂科攻0472002-19);中央保健专项资金科研课题(0627160);国家自然科学基金(编号:30471926;30671110);国家重点基础研究发展规划(973计划)项目(编号:2006CB503901);国家人类遗传资源共享平台项目(编号:2006DKA21301)资助

摘　　要：目的了解药物综合干预代谢综合征(MS)是否可以改变发生心脑血管事件的风险。方法采用随机整群抽样南宁市两个社区的1215人符合纳入标准为本次综合干预治疗的研究对象,随机分为强化干预组和对照组。强化干预组人群按照是否患有MS及其相关疾病、疾病前状态(包括高血压、血压前期、肥胖、超重、糖尿病、糖耐量减退、血脂异常)等分别采取不同的强化治疗方案进行干预;对照组人员维持志愿就诊和志愿服药的正常医疗状态,每年随访1次,按WHO-MONICA方案心血管病事件(CVD)的诊断标准登记本年度发生的CVD和死亡事件。结果前瞻性随访研究43.5个月后:①经比较对照组中MS亚组与非MS亚组,MS患者发生心脑血管事件比非MS显著增高(P=0.02);②经比较干预组中MS亚组与非MS亚组,干预后MS心脑血管事件下降明显,MS患者发生心脑血管事件与非MS相比无差异(P>0.05);③经比较干预和对照两组MS亚组之间心脑血管事件的发生率,干预组为2.7%,对照组为10.1%,差异显著(P=0.03,OR值=4.01,95%CL:1.07-15.10);两组非MS亚组之间心脑血管事件的发生率分别为2.3%和4.2%,无显著性差异(P=0.12)。结论药物综合干预代谢综合征(MS)可以改变发生心脑血管事件的风险,与对照相比干预后风险降低了约4倍。Objective To understand whether the comprehensive drug intervention of metabolic syndrome （MS） can change the risk to cardiovascular events. Methods We used a random cluster sampling of Nanning City in line with the two communities included in the standard 1215 as an integrated intervention in the treatment of subjects,which were randomly divided into strengthening intervention and control groups. Strengthen the intervention groups which according to whether or not people suffer from MS and related diseases,pre-disease state （including hypertension,pre-hypertension,obesity,overweight, diabetes,impaired glucose tolerance,dyslipidemia）,were taken to strengthen the different treatment intervention;in the control group remained voluntary medical staff and volunteers taking care of the normal state,a follow-up meeting every year, which according to the WHO-MONICA programs of cardiovascular disease events （CVD） of the diagnostic criteria for the registration took place this year and CVD deaths. Results The forward-looking follow-up study after 43.5 months ①as compared with the control group in the sub-group of MS and non-MS sub-group,the probability of cardiovascular and cerebrovascular events in MS patients was significantly higher than non-MS（P=0.02）;②to compare with MS sub-group and sub-group of non-MS in the intervention group,the probability of cardiovascular and cerebrovascular events decreased significantly after MS-intervention;there is no difference in occurs cardiovascular and cerebrovascular events comparing MS patients with non-MS （P〉0.05）; ③as compared the probability of cardiovascular and cerebrovascular events which between intervene and control sub-group,2.7 percent for the intervention group and control group was 10.1 percent,there is a significant difference （P=0.03,OR value=4.01,95% CL：1.07-15.10）;between two non-MS groups the cardiovascular and cerebrovascular events rates were 2.3% and 4.2%,and there is no significant difference（P=0.12）. Conclusion comprehensiv

关 键 词：代谢综合征 社区人群 心血管病事件风险 药物综合干预 纵向随访 

分 类 号：R589[医药卫生—内分泌] R54[医药卫生—内科学] R743[医药卫生—临床医学]