格林模式健康教育对2型糖尿病患者糖化血红蛋白、血压、脂肪、体重指数变化及其控制的影响

Influence of PRECEDE model health education on changes and control of HbA1c, BP, lipids and BMI in patients with type 2 diabetes mellitus

摘要:

目的  评价格林模式健康教育（PRECEDE）对2型糖尿病（T2DM）患者糖化血红蛋白、血压、脂肪及体重指数（BMI）的变化及其控制的影响。方法  选取2010年1月-2010年12月在该院就诊的604例T2DM患者纳入本研究。将患者随机分为PRECEDE健康教育（PHPE）组和常规健康促进教育（CHPE）组，并对患者进行2年的随访。主要临床终点为24个月后随访患者糖化血红蛋白、脂肪水平、血压及BMI。结果  PHPE组患者糖化血红蛋白和收缩压（SBP）明显降低。PHPE组患者舒张压、三酰甘油及低密度脂蛋白胆固醇水平下降，但是与CHPE组比较，差异无统计学意义。两组患者随访期间BMI无明显改善。结论  PHPE是T2DM患者综合诊治的有效方法，有助于降低糖化血红蛋白和SBP水平，增加高密度脂蛋白胆固醇。

Abstract:

Objective To assess the effectiveness of PRECEDE model for health education on changes and level control of glycated hemoglobin A1c (HbA1c), blood pressure (BP), lipids and body mass index (BMI) in patients with type 2 diabetes mellitus (T2DM). Methods Totally 604 patients with T2DM in our hospital from January to December 2010 were involved in this study. The patients were randomly assigned into PRECEDE health education group and conventional health education group and followed up for 2 years. Principle clinical endpoints were HbA1c, lipids, blood pressure and BMI in the patients after 24-month follow-up. Results HbA1c and systolic pressure (SBP) had a significant drop in the PRECEDE group. The PRECEDE group demonstrated decreases in diastolic pressure, triglyceride and low-density lipoprotein levels. However, the decreases were not statistically significant compared to the patients who received conventional health education. There was not significant improvement of BMI in either group during the follow-up. Conclusions PRECEDE model for health education is an effective method for comprehensive diagnosis and treatment of T2DM patients. It promotes reduction in HbA1c and SBP levels and increase in the level of high-density lipoprotein.