强化干预代谢综合征对血脂影响的纵向随访研究：社区人群心脑血管事件前瞻性研究系列之十二

目的前瞻性对南宁市社区人群中代谢综合征组分异常进行干预，随访3年。研究探讨社区人群中应对代谢综合征的方法和有效性。方法广西南宁市部分事业单位居民社区横断面随机调查7917人，纳入1215人，完成1072例。对其中含有一项或以上血脂异常的研究对象，随机分为干预治疗组和对照组，采取饮食、运动、药物和宣教等措施，随访3年，观察血脂衍变情况。结果①干预人群与对照组人群两组合并MS组，T—Ch，TG，HDL异常比例较无MS组增高，尤以TG升高明显，其次依次为T—Ch，HDL。无MS组，LDL异常比例略为增多。②按照性别分组，血脂组分异常占同组、同性别比例，各组相当。以T—Ch升高比例为最多，HDL异常比例较小，TG，LDL居中，二者比例接近。③T-Ch，LDL基线时，对照组与干预治疗组无差异，T—Ch、LDL干预组3年时略有升高；TG干预组3年似有升高，但无统计学意义；HDL基线干预组稍高，3年后也稍高，亦无统计学意义。④本组血脂异常患者干预后相关代谢指标FBG，PBG，Fins，HOMAIR较干预前有明显降低，干预组血压干预后较干预前有降低，但无统计学意义，而对照组血压干预后较干预前稍高；两组UA和Waist指标干预后较干预前稍高。结论①MS合并血脂异常比例较无MS人群比例增高，提示MS发病机制是引发血脂异常根源；性别在本组对MS影响不明显。在本组血脂异常中，以T—Ch升高比例为最多，HDL异常比例较小，TG，LDL居中，二者比例接近。②经过3年干预治疗，本组相关代谢指标较干预前有明显降低，提示生活方式干预及药物治疗可改善MS。③经过3年干预治疗，本组血脂改善不明显，提示血脂调整可能需长期坚持努力才可获得，如不注意健康生活方式，随着时间延长，血脂正常难以维持。

Effects of strengthen intervention of community lipid with longitudinal follow-up study

Objective To explore the efficiency of intervention to Metabolic Syndrome in community population.Methods We searched randomly 7917 people in a part of enterprose community population.in GuangXi NanNing, 1215 intaked, 1072 completed.People who had one or more than one dyslipidemia were randomly divided into control group and treat group, intervene diet,exercise,drug and education,follow up 3 years to observe the change of blood fat.Results ①In MS group incorporated from treat group and control group,abnormal ratio of T-Ch,TG, HDL was higher than NMS group,in particular in TG,T-Ch and HDL were followed.In NMS group,abnormal ratio of LDL was a little higher. ②In accordance with the gender division,abnormal of blood fat composition were similar.The proportion of LDL was highest,HDL was lower,TG,LDL were in the middle and they were similar. ③In T-Ch and LDL baseline,control group was difference from treat group.in treat group,T-Ch.LDL was a little higher after 3 years;TG was up,and not statistically significant;HDL baseline was higher,and after 3 years also higher,but not statistically significant. ④In treat group,FBG,PBG,Fins,HOMAIR were sig- nificantly depress than before intervention,and blood pressure was lower,but not statistical significance;in control group, blood pressure was higher than before treatment;UA and Waist were higher after intervention in all these groups.Conclusions ①The ratio of dyslipidemia in MS was higher than those with no MS,indicating that the pathogenesis of MS was the root of triggering dyslipidemia.There was no apparent impact of sex on MS in our study.Of all the dyslipidemia,the ratio of T-Ch was the highest,the following were TG and LDL.HDL was the lowest.And there was no difference between the ratio of TG and LDL. ②Mter the there-year intervention therapy,the change of metabolism was obvious,indicated that intervention in the way of life and the treatment will be usefull for MS. ③After the there-year intervention therapy,the change of blood lipid was not obvious,it must be a long-term efforts in order to obtain lLipid adjustments,If not pay attention to a healthy lifestyle,With the extension of the time ,it is difficult to maintain normal blood lipid.