精神障碍患者代谢综合征的团体治疗效果研究

目的探讨团体治疗对精神障碍患者代谢综合征(MS)的影响。方法选择精神障碍MS患者62例为研究对象,随机分为对照组和观察组,每组31例。对照组给予常规治疗和健康教育,观察组在对照组基础上给予团体治疗。观察2组患者入组时(干预前)和第8周后(干预后)体质量指数(BMI)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)水平,比较2组观察期间遵医嘱服药、饮食控制、体育锻炼等依从性。结果干预后观察组BMI、收缩压、舒张压指数均显著低于对照组(P<0.05),干预后观察组FBG、HOMA-IR水平均低于对照组(P<0.05),观察组干预后TG、TC、LDL-C水平低于对照组,HDL-C水平高于对照组,差异均有统计学意义(P<0.05)。观察组遵医嘱服药、饮食控制、体育锻炼依从性均显著高于对照组,差异均有统计学意义(P<0.05)。结论团体治疗用于精神障碍MS患者有助于提高患者的服药依从性,有利于健康生活方式的建立。     

The effects of postal and telephone reminders on compliance with pravastatin therapy in a national registry: results of the first myocardial infarction risk reduction program.

BACKGROUND: Noncompliance with cardiovascular therapy and prevention initiatives is well documented. OBJECTIVES: The purpose of the First Myocardial Infarction (MI) Risk Reduction Program, an open-label drug registry involving mainly primary-care patients at increased risk of a first MI, was to examine the effects of postal and telephone reminders, as well as demographic and other baseline characteristics, on patient self-reported compliance with pravastatin treatment. A second objective was to determine whether regimen adherence was associated with the adoption of other lifestyle modifications recommended to decrease the risk of coronary artery disease. METHODS: Patients with risk scores of > or = 4 on a scale of -1 to +16 for men and -1 to +17 for women on the First Heart Attack Risk Test were considered to be at increased risk of a first MI and eligible for enrollment in the registry program. An elevated total cholesterol level despite dietary interventions was an additional inclusion criterion. Patients were prospectively randomized (4:1) to either an intervention involving postal and telephone reminders (about coronary risk reduction and medication compliance), which were sent during the first 2 months of pravastatin treatment, or usual care. Both groups received reminder postcards at 4 and 5 months, in addition to counseling by physicians about coronary risk reduction. At 3 and 6 months (or study discontinuation), patients completed and mailed to the program-coordinating center questionnaires concerning compliance with care, including current use of prescribed pravastatin, as well as self-reported adoption of other lifestyle modifications, such as changing eating habits, losing weight, increasing physical activity, and/or quitting smoking. Compliance with pravastatin therapy and with these coronary risk-reducing behaviors was also assessed by physicians at the 3-month follow-up visit. RESULTS: A total of 10,335 patients were in the intervention group, and 2765 received usual care. The 2 groups were well balanced at baseline with respect to age, race, and total cholesterol values. Neither early reminders nor baseline patient characteristics were significantly associated with reported pravastatin compliance rates, which were approximately 79% overall. However, according to self-reports at 6 months, regimen compliance was associated with the adoption of other coronary risk-reducing behaviors. CONCLUSIONS: The results of this study suggest that early telephone and postal reminders do not improve compliance with drug treatment or with recommended coronary risk-reducing behaviors.     

Impact of a pharmaceutical care program in a community pharmacy on patients with dyslipidemia

BACKGROUND: Inappropriate use of medications is a significant problem in health care today. A possible solution to this problem may be achieved through better control of patients' drug therapy. OBJECTIVE: To design a pharmaceutical care program for dyslipidemic patients within a community pharmacy setting that provides education in the areas of medication compliance and lifestyle modifications, while emphasizing the importance of achieving cholesterol goals to ensure improvement in quality of life. METHODS: Patients at an outpatient pharmacy volunteered to be surveyed for 16 weeks. Although both the intervention and control groups were surveyed, the randomly selected intervention group was interviewed more frequently and more comprehensively. Cholesterol, triglycerides, glucose, weight, risk factors, drug-related problems (DRPs), and quality of life were measured via a survey at the onset of the study and continually measured until the study's conclusion. RESULTS: In the intervention group, 26 DRPs were detected, of which 24 were resolved; in the control group, 26 DRPs were detected, of which 5 were resolved. When comparing initial and final blood cholesterol levels in the intervention group, the mean decrease was 27.0 +/- 41.1 mg/dL (p = 0.0266); in the control group, the average blood cholesterol level decreased by a mean of 1.4 +/- 37.2 mg/dL (p = 0.6624). In the intervention group, the triglyceride level decreased an average of 50.5 +/- 80.3 mg/dL (p = 0.0169), while the control group experienced a mean triglyceride level increase of 29.6 +/- 118.5 mg/dL (p = 0.1435). As a result of the intervention, the quality of life in the intervention group was improved. CONCLUSIONS: Short-term pharmaceutical care plans developed in a retail pharmacy within the proper setting may contribute to improved blood lipid values, cardiovascular disease risk factors, and patients' quality of life.     

Management of dyslipidaemia in HIV-infected patients receiving antiretroviral therapy

Dyslipidaemia associated with the treatment of HIV infection, particularly with the use of protease inhibitors (PIs), can raise cholesterol and triglyceride (TG) levels to the thresholds indicated for intervention. Recent evidence from epidemiological studies has shown that there are correlations between antiretroviral drug use and increased risks for, and incidences of, cardiovascular disease, including myocardial infarction and coronary heart disease. The primary goals of dyslipidaemia therapy for HIV patients are reductions of both low-density lipoprotein cholesterol (LDL-C) and markedly elevated TG levels. Dietary strategies and exercise programs may be tried, although these have shown inconsistent results. The two options for drug therapy are switching antiretroviral agents and using lipid-lowering drugs. Each approach is associated with advantages and limitations, and the need to maintain viral suppression must be balanced with the need to treat abnormal lipid levels. Most drug switches replace the PI component with drugs from another antiretroviral class. Selection of drug therapy for lipid lowering depends on the type of dyslipidaemia predominating and the potential for drug interactions. The use of the statins pravastatin and atorvastatin is recommended for the treatment of patients with elevated LDL-C levels and gemfibrozil or fenofibrate for patients with elevated TG concentrations. Development of new PIs with more favourable effects on the lipid profile should be of benefit.     

Management of dyslipidemias in the age of statins

Evidence for the effectiveness of lipid-lowering therapy in reducing CHD risk continues to emerge. In primary prevention, clinical trials have demonstrated a benefit for middle-aged, high-risk men with high LDL cholesterol and, more recently, for men and women with "average" LDL and low HDL cholesterol. Although low HDL cholesterol, small dense LDL particles, elevated lipoprotein (a), elevated apolipoprotein B, and the dyslipidemia of the metabolic syndrome pose an increased in CHD risk in some patients, the risk reduction with lipid-lowering therapy has not been fully investigated. The CHD risk of isolated hypertriglyceridemia remains uncertain. Very high triglyceride levels, however, should be treated to prevent pancreatitis. A lipid-lowering diet and other appropriate lifestyle changes constitute safe advice for all patients with dyslipidemia. In initiating pharmacologic therapy, physicians should view potential risk reduction in the context of a patient's overall CHD risk. The selection of particular medications can be individualized, considering effectiveness evidence from clinical trials, lipid-lowering potency, adverse effects, drug interactions, costs, and patient preferences.     

Clinical impact of a pharmacist–physician co-managed programme on hyperlipidaemia management in Hong Kong

Objective: The study aimed to investigate the clinical impact of pharmacist–physician co‐managed programme on the management of hyperlipidaemia. Methods: The study was a prospective randomized controlled trial. Adult patients were selected if: (i) they were taking one or more lipid‐lowering agents with a valid lipid panel before their next follow up; (ii) had a baseline lipid profile within the previous 6 months; (iii) their lipid panel did not reach the targeted low‐density lipoprotein‐cholesterol (LDL‐C) goal based on the National Cholesterol Education Programme Adult Treatment Panel III. Pharmacists interviewed patients in the intervention group for 15–30 min to provide consultation on the drug regimen and lifestyle modifications. A telephone follow‐up every 4 weeks and a follow‐up interview on the date of the physician visit were scheduled. Patients in the control group received routine conventional care. The primary outcome measurement was the change in lipid panel between baseline and at the end of study. Results: One hundred and eighteen patients were recruited to the study [58 patients in intervention group (mean age 63 ± 10 years old) and 60 in control group (mean age 61 ± 12 years old)]. Starting with similar baseline levels, the end of study LDL‐C and total cholesterol levels for the intervention and control groups were LDL‐C: 2·80 ± 0·89 mmol/L and total cholesterol 4·75 ± 1·08 mmol/L vs. LDL‐C: 3·24 ± 0·78 mmol/L and total cholesterol 5·18 ± 0·93 mmol/L, respectively. The differences were statistically significant (P < 0·0015). Conclusion: The study showed that a pharmacist–physician co‐managed programme for hyperlipidaemic patient was effective in getting more patients to reach their target lipid levels.     

Achieving National Cholesterol Education Program goals for low-density lipoprotein cholesterol in cardiac patients: importance of diet, exercise, weight control, and drug therapy.

OBJECTIVE: To determine how frequently the National Cholesterol Education Program (NCEP) goal of a low-density lipoprotein (LDL) cholesterol level of 100 mg/dL or less is achieved in clinical practice in patients with coronary artery disease and what fraction of patients can achieve this goal without drug therapy. DESIGN: We examined the results of lipid management in 152 consecutive patients who had completed cardiac rehabilitation after an acute coronary event. Patients were randomized to follow-up by specially trained nurses or by preventive cardiologists, and they were not receiving lipid-lowering drugs at the start of the study. MATERIAL AND METHODS: Patients were given aggressive diet and exercise recommendations and lipid-lowering drugs in accordance with NCEP guidelines. Follow-up was continued for a mean of 526 days after the first lipid assessment subsequent to the coronary event. Multiple logistic regression analysis was used to identify independent predictors of a final LDL cholesterol level of 100 mg/dL or less. RESULTS: Of the study group, 39% achieved the NCEP goal LDL cholesterol level of 100 mg/dL or less. Characteristics of the patients with LDL cholesterol levels of 100 mg/dL or less in comparison with those with LDL cholesterol levels of more than 100 mg/dL included a greater frequency of drug therapy (65% versus 38%), more rigorous dietary compliance, longer follow-up (586 +/- 317 days versus 493 +/- 264 days), more favorable weight change (-0.3 +/- 4.9 kg versus +1.7 +/- 5.0 kg), and more extensive weekly exercise (183 +/- 118 minutes versus 127 +/- 107 minutes). CONCLUSION: The registered nurses managed the lipids of these patients as effectively as did the preventive cardiologists. Appropriate drug therapy was the most important factor in achieving an LDL cholesterol level of 100 mg/dL or less, but 35% of patients attaining this NCEP goal were not receiving drug therapy. Exercise, dietary compliance, and weight loss were also important factors.     

SCREENING AND TREATMENT FOR HYPERUPIDAEMIA IN NON-INSULIN-DEPENDENT DIABETES: A PROSPECTIVE ASSESSMENT OF 350 PATIENTS

SUMMARY This report presents experiences in screening 350 non-insulin-dependent diabetics for hypercholesterolemia and results of 1 year's treatment. Mean serum total cholesterol was 6.4 mmol/l at screening; 46 patients whose initial total serum cholesterol was above 7.0 mmol/l attended for detailed assessment and treatment. Mean total cholesterol concentrations fell between screening and review (7.8 vs 7.1 mmol/l, P<0.01). Levels fell below 7.0 mmol/l in 13 patients with diet alone. After excluding patients with secondary dyslipidaemia (including poor diabetic control), 10 patients received lipid-lowering drug treatment. Total cholesterol and triglyceride concentrations fell significantly and the HDL/non- HDL cholesterol ratio improved on treatment. Screening diabetic patients identifies a small group of hyperlipidaemic patients, whose lipoprotein profiles improve with drug treatment. Many of those screened, however, do not ultimately require drug treatment using a cut-off of 7.0 mmol/l.     

心肌梗死患者血糖控制水平对他汀类药物调脂效果的影响

目的研究心肌梗死患者血糖控制情况对调脂治疗效果的影响。方法将174例急性或陈旧性心肌梗死患者按是否合并糖尿病以及2年复查时血糖控制情况,分为糖尿病血糖控制良好组(DM+W组)、糖尿病血糖控制不佳组(DM+B组)、非糖尿病血糖控制良好组(NDM+W组)和非糖尿病血糖控制不佳组(NDM+B组),比较治疗前后及各组之间血脂水平、他汀类药物服药剂量和药物不良反应发生率。结果全部174例心肌梗死患者中合并糖尿病者51例(25.9%)。2年复查时DM+B组患者为13例(占糖尿病患者总数的25.5%),NDM+B组患者为24例(占非糖尿病患者总数的19.5%),这两组患者血浆总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-c)和低密度脂蛋白胆固醇(LDL-c)平均水平较入选时均无明显变化,LDL-c平均水平呈增高趋势。但即使DM+W组患者血浆LDL-c平均水平(2.57mmol/L)也未达到指南建议的<2.06mmol/L的标准。糖尿病与非糖尿病患者在他汀类服药方式上无明显差异,在2年复查时坚持按常规剂量服药者仅53.4%,采用较低剂量者占34.5%,未服药者占9.2%。合并糖尿病者长期服用他汀类药物未增加肝酶异常发生率。结论心肌梗死后血糖控制不佳使他汀类药物调脂治疗效果下降,合并糖尿病者他汀类药物服药剂量不足更为明显。     

社区老年糖尿病35例程序式居家护理

目的:探讨程序式居家护理对社区老年糖尿病患者血糖控制及治疗依从性的影响.方法:将70例社区老年糖尿病患者随机分为居家组和对照组各35例,居家组给予程序式居家护理,对照组给予常规社区护理,均干预6个月,比较两组干预效果.结果:居家组干预后血糖控制效果与对照组比较差异有统计学意义(P<0.05),居家组治疗依从性中用药、饮食及运动依从性与对照组比较差异有统计学意义(P<0.05).结论:程序式居家护理可提高社区老年糖尿病患者的治疗依从性和血糖控制效果,值得推广应用.     

Lipid-lowering and anti-inflammatory effects of tetradecylthioacetic acid in HIV-infected patients on highly active antiretroviral therapy

BACKGROUND: Highly active antiretroviral therapy (HAART) often leads to a dramatic improvement in clinical, viral and immunologic parameters in HIV-infected individuals. However, the emergence of long-term side-effects of HAART and in particular dylipidaemia is increasingly reported. Based on the potential lipid-lowering and immunomodulatory properties of tetradecylthioacetic acid (TTA) we examined whether TTA in combination with dietary intervention could modify lipid levels in peripheral blood in HIV-infected patients on HAART. MATERIALS AND METHODS: Ten HIV-infected patients on protease inhibitor-based HAART with hyperlipidaemia followed a cholesterol-lowering diet throughout the study period (8 weeks). During the last 4 weeks of the study all patients received TTA (1 g qd) in addition to the cholesterol-lowering diet. RESULTS: Our main and novel findings were: (i) TTA in combination with dietary intervention reduces total cholesterol, LDL cholesterol, triglycerides and LDL/HDL cholesterol in these patients, and a particularly suppressing effect was observed during the TTA phase regarding total cholesterol. (ii) During the TTA phase, the cholesterol-lowering effect was accompanied by a significant reduction in plasma levels of tumour necrosis factor alpha. (iii) Our studies in peripheral blood mononuclear cells from these patients and in the liver from wild-type mice receiving TTA suggest that the hypolipidaemic effects of TTA may involve up-regulation of scavenger and LDL-receptor expression. CONCLUSIONS: Although few patients were studied, the present pilot study suggests that TTA combined with dietary intervention could be an interesting therapeutic approach in HIV-infected patients on HAART, potentially resulting in both hypolipidaemic and anti-inflammatory effects.     

A randomised controlled trial to evaluate a nurse-led programme of support and lifestyle management for patients awaiting cardiac surgery 'Fit for surgery: Fit for life' study.

BACKGROUND: The 'Fit For Surgery' programme was based on previous studies suggesting improvement in risk factors contributing to coronary disease while patients wait for cardiac surgery. AIM: To evaluate our nurse-led programme in a randomised controlled trial with 188 patients. METHODS: Patients listed for coronary artery bypass surgery with at least one poorly controlled risk factor were randomised to standard care or the intervention which provided lifestyle counselling and preparation for surgery at monthly intervals. Primary outcome measurements were anxiety, blood pressure, cholesterol, length of stay and body mass index. Costs of the intervention were also collected. RESULTS: For both groups blood pressure and total cholesterol improved (Blood pressure mm Hg (Control -9.11 (CI -4.89, -13.33); Intervention -13.02 (CI -8.76, -U17.29) both p<0.01); total cholesterol (Control -0.20 (CI -0.03, -0.37) p=0.02, Intervention -0.18 (CI -0.02, -0.34) p=0.03). However there were no significant differences between the groups. Cost minimization analysis showed that the total costs were less in the intervention group due to fewer admissions (total costs pound10,754 (3746) v pound13,047 (5835), CI -3743, -843; p=0.002). CONCLUSIONS: The nurse-led programme did not appear to reduce risk factors prior to coronary artery bypass surgery. However, the intervention appears to reduce overall healthcare utilization.     

Identifying patients at risk for coronary heart disease: implications from trials of lipid-lowering drug therapy

Abnormal lipid levels contribute significantly to the risk of coronary heart disease (CHD), which is increased further in the presence of other risk factors. The association between elevated low-density lipoprotein (LDL) cholesterol and CHD risk is well established, and large primary and secondary prevention studies of HMG-CoA reductase inhibitors (statins) have shown conclusively that lowering LDL cholesterol levels reduces CHD events and total mortality. Regardless of the intervention used (diet, surgery, drugs), reduction of plasma cholesterol has consistently produced a reduction in cardiovascular risk. Absolute benefit is greatest in those who are at highest risk initially, and trial results suggest that the lower the LDL cholesterol level achieved, at least down to LDL of 3.0 mmol/l, then the lower is the CHD event risk. Epidemiological data also point to the negative impact of other lipids on CHD risk. Low levels of high-density lipoprotein (HDL) and high levels of triglycerides (particularly in conjunction with an LDL/HDL ratio >5) are particularly strong risk factors for CHD. Thus, although prevention trials to date have primarily assessed the impact of LDL lowering on CHD events, the initial assessment of CHD risk should consider a more detailed atherogenic profile including HDL and triglyceride levels. A general approach to preventing cardiovascular disease should include strategies to reduce the overall CHD risk by lifestyle modification and management of modifiable risk factors such as smoking, hypertension and diabetes. Based on data from recent prevention studies, and because they are the most potent lipid-lowering agents available for lowering LDL cholesterol, statins have appropriately become the drug of choice for most patients with hyperlipidaemia who require drug therapy.     

社区护理干预对糖尿病病人遵医行为影响的研究

[目的]探讨糖尿病的社区护理干预对控制糖尿病及并发症的发生的效果.[方法]将已经确认在医院住院用药治疗后出院的56例糖尿病病人随机分成实验组和对照组,每组28例,两组在住院期间皆接受了系统的健康教育,在饮食疗法,药物疗法,血、尿、糖的自我监测,运动疗法等方面进行了指导,并在出院时给予书面内容指导,嘱其出院后按指导内容进行糖尿病控制.出院后对实验组进行社区护理干预,而时照组则不施加任何影响.1年后时两组糖尿病病人的遵医行为、血糖控制情况、再次住院病例及并发症发生率进行评估.[结果]实验组糖尿病病人的遵医行为较对照组好,血糖控制优于时照组,再次住院病例较对照组少,并发症发生率较对照组低(P＜0.05).[结论]社区护理干预对糖尿病病人的遵医行为及糖尿病病情的控制有非常重要的意义.     

多元化健康教育对正常高值血压人群生活方式的影响

目的：探讨多元化健康教育对正常高值血压人群生活方式的影响。方法纳入我院2013年1月至2014年2月100例正常高值血压患者,研究对象按照随机分组方法分成对照组和观察组,对照组采用常规护理方式,观察组采用多元化健康教育模式的干预方式,内容包括鼓励患者低盐低脂饮食、改变不良生活习惯、禁止烟酒、适当运动,在干预第6个月评估各项观察指标,检测内容包括血压、血脂、体重等体检报告,并采取调查分析报告观察正常高值血压后生活方式的改变以了解干预效果,使用HPLP生活方式量表评价两种干预模式对生活质量的影响。结果两组患者干预后6个月收缩压、舒张压、血脂与干预前比较具有统计学差异( P<0．05);干预6个月后观察组总胆固醇、体重指数与干预前比较具有统计学差异,且明显低于对照组(P<0．05),患者的认知行为干预与对照组相比其生活方式的改变、坚持运动人数增多,高盐高脂饮食、吸烟饮酒人数减少,两组间比较具有统计学差异( P<0．05);观察组患者的HPLP 总均分及各维度得分均高于对照组患者,两组比较差异具有统计学意义( P<0．05)。结论通过多元化健康教育能纠正正常高值血压人群的不良生活习惯,提高患者的依从性,改善患者的代谢水平,从而改善患者生活质量。     

临床路径在社区高血压患者中的应用

目的探讨临床路径在社区高血压患者中的应用效果。方法将535例上海市罗店社区的高血压患者按随机数字表法分为2组：干预组246例和对照组289例。干预组采用临床路径进行干预,对照组采用社区防治模式进行干预。同时对2组患者采用降压药物治疗。观察2组患者干预后满意度、药物治疗依从性及血压『收缩压（SBP）、舒张压（DBP）]控制水平等情况。结果干预组患者干预后满意度显著高于对照组,差异有统计学意义（P〈0．05）;干预组患者干预后药物治疗依从性显著高于对照组,差异有统计学意义（P〈0．05）;干预组患者干预后SBP、DBP控制水平均优于对照组（均P〈0．05）。结论实施临床路径提高了患者的自我管理能力,增加了患者的高血压控制效果,是提高社区高血压患者疗效的可行模式。     

Hydroxycholesterols in serum from hypercholesterolaemic patients with and without bile acid sequestrant therapy

To assess the effect of bile acid sequestrant therapy on bile acid precursors in plasma, we determined hydroxycholesterols in serum from patients with primary hypercholesterolaemia. Compared with a group of 5 male and 12 female patients without any lipid-lowering drug therapy, which has normal to slightly elevated 7 alpha-hydroxycholesterol, normal 7 beta-hydroxycholesterol and high normal to elevated 26-hydroxycholesterol levels, a group of 5 male and 9 female patients, using colestipol had higher 7 alpha-hydroxycholesterol without overlap, and higher 7 beta-hydroxycholesterol levels, but similar levels of 26-hydroxycholesterol. In the latter group, the ratio between 7 alpha-hydroxycholesterol and total cholesterol in serum was also higher without overlap. Both groups did not differ for age, body weight, body mass index and serum lipid levels. In the group of patients without lipid-lowering drug therapy, 7 alpha-hydroxycholesterol correlated positively with total and low-densitylipoprotein cholesterol, 7 beta-hydroxycholesterol negatively with body weight and body mass index, and 26-hydroxycholesterol positively with body weight. In both groups, 7 alpha-hydroxycholesterol correlated positively with 7 beta-hydroxycholesterol. These results suggest that (1) bile acid sequestrants enhance bile acid synthesis via the 7 alpha-hydroxylation but not via the 26-hydroxylation pathway, (2) serum 7 alpha-hydroxycholesterol level and the ratio between this hydroxycholesterol and total cholesterol in serum might be suitable parameters to check intake of bile acid sequestrants irrespective of dose, and (3) 7 beta-hydroxycholesterol is unlikely to be the result of cholesterol auto-oxidation in vitro.     

规范生活方式干预对老年2型糖尿病患者疗效观察

目的 研究在药物治疗的基础上规范生活方式管理,对老年2型糖尿病患者疗效的观察.方法 选择无运动禁忌证的老年2型糖尿病患者270例,采用“生活方式疾病综合防治系统”管理软件和“能量监测仪”指导生活方式,检测患者空腹血糖(FPG)、餐后血糖(PPG)、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、体质量指数(BMI)、糖化血红蛋白(HbAlc)、血压、每日总摄入量、总运动量及有效运动量等指标,观察治疗6个月,进行前后自身对照评价其疗效.结果 经过6个月的规范化生活方式干预:(1)2型糖尿病患者体重、BMI、腰围、收缩压及舒张压均有极显著下降(t值分别为:23.82、25.91、19.56、23.37和19.53,P均＜0.01)；FPG、PPG、HbA1c、CHOL、TG、LDL较干预前有极显著下降(t值分别为:12.06、11.82、9.74、6.98、5.79和6.10,P均＜0.01),HDL有显著升高(t=2.51,P＜0.05).(2)每日总摄入量较干预前明显减少,有效运动量显著提高,与干预前比较差异均有统计学意义(P均＜0.01).结论 规范生活方式管理,更有助于控制糖尿病患者血糖、血压和体质量等危险因素,减少其并发症,降低医疗费用.     

糖尿病并发阿尔茨海默病患者的临床干预措施

目的：研究护理干预对糖尿病并发阿尔茨海默病患者的临床意义。方法研究筛选138例患者,按随机数字表法分为干预组和对照组,干预组采用治疗辅导、饮食控制、心理辅导以及基本生活作息指导等护理干预措施来观察各项措施的疗效情况。结果在治疗半个月和1个月后,干预组的餐后2 h血糖和空腹血糖与对照组比较均明显下降,且两组间比较差异有统计学意义（ t分别为-2．890,-2．971,-2．822,-2．819;P＜0．05）。同时,干预组患者对护理人员的满意度比例高于对照组,差异有统计学意义（69．57％比46．38％;Z＝-2．966,P＜0．05）。结论护理干预对于并发阿尔茨海默病的糖尿病患者能够很好地促进其病情趋于良好转归,增加其依从性。