生活方式干预常见慢性非传染性疾病高危人群的初步研究

目的评价健康管理体系中对慢性非传染性疾病（慢病）高危人群生活方式干预的效果。方法将来自5个健康管理单位的229名慢病前期人员根据指标异常情况分为4组：血压异常组（67人）；血糖异常组（38人）；胆固醇异常组（71人）和骨量减少组（53人）。在1年中进行综合生活方式和行为干预，内容包括健康教育、有氧运动、平衡饮食、戒烟、补钙及日晒等。各组分别于干预前，干预12个月时进行相关的血压、血糖、血脂和骨量测定。结果干预12个月后。各组的被管理者指标均取得显著改善：血压异常组的收缩压／舒张压分别下降了9．4mmHg／6．6mmHg（1mmHg=0．133kPa，t=5．93／8．29．P〈0．05）；血糖异常组和血脂异常组的血糖和血脂分别下降了0．9mmol／L（t=3．69，P〈0．05）和0．5mmol／L（t=4．09，P〈0．05）；而骨量减少组的腰椎骨密度上升了0．015g／cm^2（t=2．03，P〈0．05）。结论就慢病预防而言，1年的综合生活方式干预使被管理者在饮食、运动及生化学指标方面得到明显改善，这种切实可行的干预措施能有效的预防慢病的发生和发展，并应在健康管理体系中加以应用。

Primary effects of comprehensive lifestyle modification on status of pre-chronic diseases

Objective To evaluate the effectiveness of comprehensive lifestyle modification in the primary health care system on status of pre-chronic diseases in a conventional heahhcare program. Methods Two hundred and twenty-nine adult volunteers in 5 conventional healthcare centers were divided into 4 groups ： group of prehypertension （ n = 67 ）, group of prediabetes （ n = 38 ）, group of abnormity serum cholesterol （n = 71 ） and group of osteopenia （n = 53）. A multicomponent behavioral intervention including education, physical activity, dietary practice, cease smoke, calcium supplement and exposure to sunlight was conducted for 12 months. The main outcome of each group was blood pressure, blood glucose, serum cholesterol and bone mineral density. Results Over 12 months, compared with the status before intervention, participants in each group were statistically significantly improved, the mean net reduction in systolic BP / diastolic BP was 9.4 mm Hg/6. 6 mm Hg （ 1 mm Hg =0. 133 kPa,t =5.93/8.29. P 〈0. 05） in group of prehypertension ; the reductions of blood glucose, serum cholesterol were 0. 9 mmol/L （ t = 3.69, P 〈 0. 05 ） and 0.5 mmol/L （ t = 4. 09, P 〈0. 05 ） in group of prediabetes and group of abnormity serum cholesterol, and the increase of bone mineral density on lumbar spine was 0. 015 g/cm^2 （ t = 2. 03, P 〈 0. 05 ） in group of osteopenia. Conclusions For chronic disease prevention, ater one year the comprehensive lifestyle intervention produced beneficial changes in diet, physical activity, and biochemical parameters. This type of intervention is a feasible option to prevent chronic disease and should be implemented in the primary health care system.