三维斑点追踪技术评估肥胖儿童左室功能变化及其与C反应蛋白的关系

发布时间：2018-07-06 16:48

本文选题：儿童 + 肥胖症　；参考：《南昌大学》2017年硕士论文

【摘要】：目的:运用三维斑点追踪技术定量分析肥胖症儿童左心室收缩功能的变化,并探讨其与血清C反应蛋白水平变化的关系,帮助临床评估肥胖症儿童心血管疾病的风险,为它们的早期临床干预提供依据。方法:选取7-15岁的肥胖儿童55例为肥胖组,超重儿童39例为超重组,并选取年龄、性别相匹配的正常体重儿童44例为对照组。研究对象均接受常规二维超声心动图检查,测量左室舒张末期、收缩末期内径(LVEDD、LVESD),左室舒张末期容积和收缩末期容积(LVEDV、LVESV),左室射血分数(LVEF),舒张末期室间隔厚度和左室后壁厚度(IVST、LVPWT),计算左室相对室壁厚度(RWT)。应用Tom-tec工作站中的三维斑点分析软件分析三维全容积动态图,自动计算出左室整体径向应变(GRS)、纵向应变(GLS)、圆周应变(GCS)及扭转角度(GTA)、左室质量(LVM)。所有研究对象均采集空腹晨血5ml离心后应用特定蛋白分析系统检测血清C反应蛋白(CRP)水平。比较肥胖、超重、正常组之间左室收缩功能等相关指标及血清CRP水平的差异,并分析CRP与它们之间的相关性。结果:1)肥胖组儿童较对照组儿童IVST、LVPWT、RWT增加,有显著性差异(P0.05);较超重组儿童IVST、LVPWT、RWT增加,有显著性差异(P0.05)。2)肥胖组儿童较对照组儿童GRS、GLS、GCS、GTA减低,LVM增加,有显著性差异(P0.05);超重组儿童较对照组儿童GRS、GLS、GCS减低,有显著性差异(P0.05)。3)肥胖组儿童较超重组、对照组儿童血清CRP水平均明显升高,有显著性差异(P0.05);超重组儿童血清CRP较对照组儿童明显升高,有显著性差异(P0.05)。血清CRP水平与BMI呈显著正相关(r=0.59,P0.05)。4)血清CRP水平与GRS、GLS、GCS呈一定的负相关性(r=-0.41,P0.05;r=-0.36,P0.05;r=-0.40,P0.05);CRP水平与RWT、LVM呈一定的正相关性(r=0.29,P0.05;r=0.29,P0.05)。结论:1)儿童在向肥胖发展的早期其左心室收缩功能就已出现受损。2)在儿童肥胖早期,血清C反应蛋白水平已明显升高,且与左心室功能受损有着密切联系。3)三维斑点追踪技术可对肥胖症儿童左室心肌功能进行定量分析,且较常规二维超声心动图更敏感、精确地检测出心肌功能的早期改变。
[Abstract]:Objective: to study the relationship between the changes of left ventricular systolic function and serum C-reactive protein (CRP) levels in obese children by using three-dimensional speckle tracing technique to evaluate the risk of cardiovascular disease in obese children. To provide basis for their early clinical intervention. Methods: 55 obese children aged 7-15 years were selected as obese group, 39 overweight children as superrecombinant group, and 44 normal weight children of age and sex matched as control group. All subjects were examined by conventional two-dimensional echocardiography to measure left ventricular end-diastolic function. Left ventricular relative wall thickness (RWT), left ventricular end-diastolic volume and end-systolic volume (LVEDVV / LVESV), left ventricular ejection fraction (LVEF), left ventricular septal thickness and left ventricular posterior wall thickness (IVST-LVPWT) were calculated by endsystolic diameter (LVEDDD), left ventricular end-diastolic volume (LVESD), left ventricular end-diastolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular posterior wall thickness (IVST-LVPWT). Using the software of 3D speckle analysis in Tom-tec workstation to analyze three-dimensional full-volume dynamic images, the global radial strain (GRS), longitudinal strain (GLS), circumferential strain (GCS), torsion angle (GTA) and left ventricular mass (LVM) were calculated automatically. Serum C-reactive protein (C-reactive protein) levels were measured by specific protein analysis system after fasting morning blood 5ml centrifugation. The relative indexes of left ventricular systolic function and serum CRP were compared between obese, overweight and normal group, and the correlation between CRP and CRP was analyzed. Results the RWT of the obese children was significantly higher than that of the control group (P0.05), and the RWT of IVST-LVPWT-RWT was significantly higher than that of the control group (P0.05), and the RWT of the obese children was significantly higher than that of the control group (P0.05). The increase of LVM in obese children was lower than that in the control group (P0.05). There was significant difference (P0.05); GRSS-GLSN GCS in overweight children was lower than that in control group (P0.05). The serum CRP level in obese children was significantly higher than that in control group. There was significant difference (P0.05); the serum CRP of superrecombinant children was significantly higher than that of the control group (P0.05). There was a positive correlation between serum CRP level and BMI (r 0.59% P0.05). There was a certain negative correlation between serum CRP level and GRSs GLSN GCS (r-0.41% P 0.05 P 0.05 P 0.05 r-0.40 P 0.05). There was a certain positive correlation between CRP level and RWTLVM (r 0.29 P 0.05 P 0.05 P 0.29 P 0. 29 P 0. 29 P 0. 05 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29). Conclusion: (1) at the early stage of obesity, the left ventricular systolic function of children has been impaired by .2) at the early stage of childhood obesity, the level of serum C-reactive protein has been significantly increased. 3) Three-dimensional speckle tracing technique can be used to quantitatively analyze left ventricular function in obese children. It is more sensitive than conventional two-dimensional echocardiography and can accurately detect the early changes of myocardial function.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R723.14;R540.45

【参考文献】