老年代谢综合征患者临床特点及控制达标情况分析

目的了解老年代谢综合征（MS）患者的临床特点、用药情况及代谢异常组分的控制达标状况。方法回顾性分析2006年8月至2009年8月在本院体检或住院MS患者共267例，其中老年人145例，中年人122例。分析中、老年患者MS各组分的差异，老年患者用药情况以及各代谢异常组分控制达标水平。结果老年MS患者的空腹血糖、餐后血糖和收缩压均高于同性别的中年患者，而舒张压无显著差异。老年患者的尿酸水平高于中年患者。老年MS合并糖尿病患者中，97．3％应用药物控制血糖，以磺脲类、α-糖苷酶抑制剂、胰岛素为主，药物联合治疗的达标率为64．7％；老年MS合并高血压患者中，94．7％服用降压药物，以钙通道阻滞剂（CCB）和血管紧张素Ⅱ受体阻滞剂（ARB）为主，两种以上降压药物联合治疗的达标率为56．2％。结论老年MS患者各组分的异常程度和出现频率均不同于中年人，老年MS患者的治疗比例较高，但各组分控制达标率仍不高，联合治疗可有效提高各组分的控制达标率。

Clinic analysis clinical features and distribution of abnormal metabolic components of metabolic syndrome

Objective To investigate the different clinical features of metabolic syndrome （MS） in middle -aged and elderly patients and the treatment and the distribution of abnormal metabolic components in elderly patients. Methods 267 MS patients were from 2006 to 2008, 145 were elderly people and 122 were in middle - age. Laboratory examination and medical history were analyzed. 145 elderly patients were were analyzed to evaluate medicine used and the distribution of several abnormal metabolic components. Results Body mass index （ BMI）, Fasting blood glucose, postprandial blood glucose, systolic BP and uric acid in elderly patients were higher than that in the middle -aged patients. 97.3% diabetes patients were suffered from MS, for whom the medicine was used to control the blood glucose, including sulfonylureas, AGI and insulin. In those patients, 64.7% were up to the normal level on blood glucose with combination therapy. Among the patients with hypertension, and 94. 7% used medicine for controlling blood pressure, including CCB and ARB. There were 78.4% of 60 patients who took medicine for controlling blood lipid, 56. 2% and 77. 8% were up to the normal level on blood pressure and blood lipid with combination therapy, respectively. Conclusion The frequency and abnormal degree of MS components in elderly patients are differents from those of the middle - aged patients. It＇s hard to get an ideal result on controlling the abnormal metabolic components. For the patients with abnormal metabolic components, it＇s better to treat with combination therapy.