肥胖患者营养与行为干预研究

目的 探索和评价营养和行为干预对肥胖患者体重及生化指标的影响.方法 选取本院体检中心100名肥胖患者,检测体重、身高、腰围、臀围、血压（BP）并计算身体质量指数（BMI）和腰臀比;同时采集研究对象血样,检测三酰甘油（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血糖（FPG）和血尿酸（UA）.进一步通过单纯随机抽样选取50例,一对一进行营养知识行为指导,进行合理膳食结构调整及改变不良生活方式.50例对照组仅给予医学对症处理,干预时间为1年,之后重新测定患者体重及生化指标.结果 干预组干预后,BMI （P＜0.001）、TG （P＜0.001）、TC（P=0.036＜0.05）、LDL-C （P=0.001＜0.05）、FPG（P=0.006＜0.05）和UA （P＜0.001）均较干预前下降,而对照组干预后各指标与干预前比较差异无统计学意义;干预后,干预组舒张压（P=0.02＜0.05）三酰甘油（P＜0.001）、胆固醇（P＜0.001）、高密度脂蛋白胆固醇P＜0.001）、低密度脂蛋白胆固醇（P＜0.001）、血糖（P＜0.001）均低于对照组.结论 合理的营养和行为干预是改善肥胖患者体质的有效方式.

Study of nutrition and behavior intervention on obese patients

Objective To explore and evaluate the effect of nutrition and behavior intervention on obese patients.Methods One hundred obese male patients were randomly selected in the Central Hospital of Songjiang District of Shanghai.Body weight,height,waist-hip circumference,and blood pressure of the patients were measured,and body mass index （BMI） and waist-hip ratio were calculated.Blood samples were collected,and serum triglyceride （TG）,total cholesterol （TC）,high-density lipoprotein cholesterol （HDL-C）,low-density lipoprotein cholesterol （LDL-C）,fasting plasma glucose （FPG） and serum uric acid （UA） were measured before intervention.Fifty of the 100 patients were randomly selected as the intervention group,which were given face-to-face instructions on correcting the unhealthy behaviors,the eating habits as nutrition and behavior intervention therapy.Symptomatic treatment was also applied.The other 50 patients （the control group） were treated based on symptoms only.Body condition and blood biochemical parameters were measured again after one year of follow-up.Results BMI （P〈0.001）,TG （P〈0.001）,TC （P=0.036〈0.05）,LDL-C （P=0.001〈0.05）,FPG （P=0.006〈0.05） and UA （P〈0.001） were significantly lower after intervention in the intervention group,while no significant difference was found in the indexes after intervention in the control group （P〈0.05）.There were statistically significant differences in diastolic blood pressure （P=0.02〈0.05）,TC （P〈0.001）,TG （P〈0.001）,HDL-C （P〈0.001）,LDL-C （P〈0.001）,FPG （P〈0.001） between the two groups after intervention.Conclusion Nutrition and behavior intervention can effectively decrease BMI,serum lipid,the glucose,blood pressure,and serum uric acid of obese patients.