路径干预治疗脑梗死合并代谢综合征的血脂观察  

Observation of blood fat in patients with cerebral infarction complicated by metabolic syndrome receiving community path intervention treatment

作　　者：王晶[1] 徐如祥[1] 杨斌[2] 刘凤春[2] 王志忠[2] 

机构地区：[1]南方医科大学附属八一脑科医院南方医科大学八一临床医学院北京军区总医院附属八一脑科医院,100700 [2]北京军区总医院第三门诊部

出　　处：《中国医师进修杂志》2013年第25期32-36,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨脑梗死合并代谢综合征（Ms）患者路径干预治疗后的血脂变化。方法选择脑梗死合并MS患者116例，根据患者依从性的不同分为干预组（60例）和对照组（56例），对两组患者进行风险评估后给予综合干预治疗，并进行比较。结果两组干预后总胆固醇（TC）、三酰甘油（TO）及低密度脂蛋白胆固醇（LDL．C）均呈逐渐下降趋势，高密度脂蛋白胆固醇（HDL-C）均呈逐渐升高趋势，干预组干预前与干预后各时间点比较差异有统计学意义（P〈0．05）。干预组干预后各时间点各指标与对照组比较差异有统计学意义（P〈0．05）。两组干预前颈动脉斑块积分比较差异无统计学意义（P〉0．05）。干预组干预后12、24个月颈动脉斑块积分低于干预前，差异有统计学意义（P〈0．05）。干预组干预后12、24个月颈动脉斑块积分低于对照组[（3．20±2．01）om比（4．71±2．87）cm、（2．98±2．61）cm比（4．60±2．43）C／T／]，差异有统计学意义（P〈0．05）。干预组干预后12、24个月时，TC与颈动脉斑块积分呈显著正相关（r=0．304、0．317，P〈0．05）；TG与颈动脉斑块积分呈显著正相关（r=0．229、0．128，P〈0．05）；LDL-C与颈动脉斑块积分呈显著正相关（r=0．654、0．518，P〈0．05）；HDL-C与颈动脉斑块积分呈显著负相关（r=-0．495、-0．528，P〈0．05）。结论MS是脑梗死重要的危险因素，对于脑梗死合并MS患者，应高度重视对其各主要组成成分的早期防治，以减少脑梗死患者的急性脑血管病事件的再发和病死率。Objective To explore the changes of blood fat in patients with cerebral infarction complicated by metabolic syndrome （MS） receiving community path intervention treatment. Methods A total of 116 cases of cerebral infarction complicated by MS were selected and given comprehensive intervention treatment after risk assessment. Patients were divided into intervention group （60 cases） and control group （56 cases） according to their difference in compliance. Results After intervention,the total cholesterol （TC）,triglyceride （TG） and low density lipoprotein cholesterol （LDL-C） in two groups were significantly decreased, high-density lipoprotein cholesterol （HDL-C） was significantly increased. There were significant differences in intervention group before and after intervention （P〈 0.05 ）. Compared with those in control group, differences of all index in each time point in intervention group were statistically significant （P 〈 0.05）. There was no significant difference in carotid plaque integral before intervention between two groups （P 〉 0.05 ）. The carotid plaque integral 12 and 24 months after intervention in intervention group was significantly lower than that before intervention （P 〈 0.05）. The carotid plaque integral 12 and 24 months after intervention in intervention group was significantly lower than that in control group [ （3.20 ＋ 2.01 ） cm vs. （4.71 ＋2.87） cm, （2.98 ~2.61） cm vs. （4.60 ＋2.43） cm,P〈0.05]. Twelve and 24 months after intervention in intervention group, TC and carotid plaque integral was significantly positive correlation （r = 0.304 and 0.317 ,P 〈 0.05 ） ,TG and carotid plaque integral was significantly positive correlation （r = 0.229 and 0.128, P 〈 0.05 ）, LDL-C and carotid plaque integral was significantly positive correlation （r = 0.654 and 0.518, P 〈 0.05 ）, and HDL-C and carotid plaque integral was significantly negative correlation （r = -0.495 and -0.528, P 〈 0.05 ）. Conclusion For patients of

关 键 词：脑梗塞 代谢综合征X 路径干预治疗 

分 类 号：R473.74[医药卫生—护理学]