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目的探讨心血管疾病(CVD)与代谢综合征(MS)及其各组分的相关性;并收集未并发CVD的MS患者进行干预治疗,探讨其对CVD事件的作用。方法收集未并发CVD的MS患者,分多因子干预组(MFI)97例及加用二甲双胍组(Met组)105例,前组按其代谢异常作相应的药物治疗,后组加用二甲双胍1.5~2.0g/d,平均随访4.6年,以冠心病、脑卒中、颈或股动脉内膜中层厚度(IMT)作为心血管事件,评价两种治疗方法的疗效。结果①Logistic回归分析显示,CVD的风险因子中MS的危险性高于胰岛素抵抗指数(HOMA-IR),尿白蛋白排泄率(UAER)高于其他单一危险因子。②MFI组<3年、>3年的CVD事件发生率分别为5.1%和16.5%,明显高于Met组的3.8%和10.5%(P<0.05)。结论MS是CVD的主要风险因子,并与其各组分异常成正相关。药物干预有不同程度的疗效,但加用二甲双胍可显示较好的效果,可能由于二甲双胍兼有涵盖MS多重代谢异常的改善,早用及长期使用对保护靶器官可望取得更好的效果。
Objective To investigate the correlation between cardiovascular disease (CVD) and metabolic syndrome (MS) and its components. MS patients without CVD were collected for intervention and their effects on CVD events were investigated. Methods Ninety-seven MFI patients and 105 metformin patients were enrolled in this study. MS patients were divided into two groups according to their metabolic abnormalities: the former group received metformin 1.5 ~ 2.0g / d, with an average follow-up of 4.6 years, to evaluate the efficacy of the two treatment methods with coronary heart disease, stroke, neck or femoral artery intima-media thickness (IMT) as a cardiovascular event. Results ① Logistic regression analysis showed that the risk of MS in CVD was higher than that of insulin resistance index (HOMA-IR) and the urinary albumin excretion rate (UAER) was higher than other single risk factors. ② The incidences of CVD events in MFI group were 5.1% and 16.5% at <3 years and> 3 years respectively, which were significantly higher than 3.8% and 10.5% in Met group (P <0.05). Conclusion MS is the main risk factor of CVD and is positively related to the abnormality of each component. Drug intervention has varying degrees of efficacy, but with metformin can show better results, probably due to metformin both cover MS multiple metabolic abnormalities improved early and long-term use of the target organ is expected to achieve better results.