肥胖儿童心脏结构和功能特征

发布时间：2018-05-31 20:01

本文选题：超声心动图 + 儿童　；参考：《中国运动医学杂志》2017年07期

【摘要】：目的:评价肥胖儿童心脏结构和功能的特点,旨在评估心脏早期改变的风险性和不良后果。方法:将北京市5所小学的1034名8~9岁儿童(男n=514,女n=520)依照体脂率(BF%)分类标准,男、女各分成体脂率正常组(男n=206,女n=336)、超重组(男n=94,女n=80)、肥胖组(男n=214,女n=104)。对所有受试者进行超声心动图检查,并分性别比较各组心脏结构和功能指标。结果:(1)与体重正常儿童相比,肥胖儿童左心室舒张末期内径(LVIDd)、舒张末期左室后壁厚度(LVPWd)、左心室舒张末期容积(EDV)、左心室质量(LVM)、左心室质量指数(LVMI)、每搏量(SV)、心输出量(CO)均非常显著性增加(P0.01),但射血分数(EF)、短轴缩短率(FS)无统计学差异(P0.05)。(2)儿童BF%与主动脉根部内径(AOD)、舒张末期室间隔厚度(IVSd)、LVIDd、舒张末期左室后壁厚度(LVPWd)、EDV、LVM、LVMI、CO、SV呈正相关(P0.01)。(3)8~9岁超重肥胖儿童心脏向心性肥厚的比例为6.1%。与左室正常构型儿童相比,心脏向心性肥厚儿童形态指标BF、BF%、BMI和心脏指标LVM、LVMI、相对室壁厚度(RWT)非常显著性增加(P0.01),CO显著性增加(P0.05),SV显著性减小(P0.05)。结论:以体脂率作为肥胖筛查指标发现,8~9岁肥胖儿童发生心脏重构和功能改变,包括左心室扩大、室壁增厚、左室质量增加、左室肥厚及每搏量、心输出量增加,且随肥胖程度加重,向心性肥厚发生率增高。
[Abstract]:Objective: to evaluate the characteristics of cardiac structure and function in obese children and to evaluate the risk and adverse consequences of early cardiac changes. Methods: according to the classification standard of body fat rate, 1034 children (male NN514, female NN520) from 5 primary schools in Beijing were divided into normal body fat rate group (n = 206, n = 36), superrecombination (n = 94, n = 80), obesity group (n = 214, n = 104, n = 104). Echocardiography was performed in all subjects, and cardiac structure and function were compared by sex. Results compared with normal weight children, Left ventricular end-diastolic diameter (LVIDdN), left ventricular posterior wall thickness (LVPWdN), left ventricular end-diastolic volume (LVV), left ventricular mass (LVM), left ventricular mass index (LVMIN), ventricular mass index (LVMIA), ventricular output volume (CO) and SVV volume (SVG) were significantly increased in obese children (P 0.01). There was no significant difference between BF% and AODD, IVSdT, EDV LVMMICOSV in children (P < 0.01). The proportion of cardiac concentric hypertrophy was 6.1in overweight and obese children aged 80 years (P < 0.01), and the left ventricular septal thickness (LVPWD) and left ventricular posterior wall thickness (EDV) were positively correlated with LVPWD / LVMICOSV (P < 0.01) in children with overweight and obese children aged 89-years (P = 6.1a, P < 0.05), and the incidence of cardiac concentric hypertrophy in overweight and obese children (P < 0.05) was higher than that in children (P < 0.05). Compared with the children with normal left ventricular configuration, the BMI and LVMN LVMIs of children with cardiac concentric hypertrophy were significantly higher than those of children with normal left ventricular structure. The relative wall thickness of left ventricle increased significantly (P 0.01) and CO significantly increased (P 0.05) and SV decreased significantly (P 0.05). Conclusion: using body fat rate as a screening indicator of obesity, cardiac remodeling and functional changes occurred in obese children aged 89 years, including left ventricular enlargement, wall thickening, left ventricular mass increase, left ventricular hypertrophy and stroke volume, cardiac output increased. With the increase of obesity, the incidence of concentric hypertrophy increased.
【作者单位】：北京体育大学运动与体质健康教育部重点实验室;北京体育大学运动人体科学学院;
【基金】：北京体育大学高参小项目小学生体质测试研究(GCX2014001) 向基础教育倾斜-体育卫生与艺术教育-中小学生运动干预体系建设项目 2015北京市优秀人才培养青年骨干个人项目
【分类号】：R540.45;R723.14

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