摘要:
了解6~7岁超重肥胖儿童心脏结构和功能及其影响因素,为促进儿童心肺功能发育提供依据.方法 选取北京市2014年5所参与特色体育教育小学的部分一年级学生690名,用体质量指数(BMI)诊断标准将学生分为正常、超重、肥胖3组,进行超声心动测试,观察其心脏结构和功能及影响因素.结果 北京市6~7岁儿童超重和肥胖检出率分别为18.3%和19.7%,男童超重和肥胖检出率(10.0%和12.0%)高于女童(8.3%和7.7%),差异均有统计学意义(x2值分别为4.748,12.333,P值均<0.05).肥胖儿童的室间隔舒张末期厚度(IVSd)、室间隔收缩末期厚度(IVSs)、左室舒张末期内径(LVIDd)、左室收缩末期内径(LVIDs)、左室后壁舒张末期厚度(LVPWd)、左室后壁收缩末期厚度(LVPWs)、左室舒张末期容积(EDV)、AOD、左心室质量(LVM)、左心室质量指数(LVMI)、左室收缩末期容积(ESV)、衍生指标心输出量(CO)、每搏量(SV)均高于正常儿童(P值均<0.05);超重儿童的IVSd,IVSs,AOD,LVM均高于正常儿童,肥胖儿童的LVIDd,EDV,LVM,CO,SV均高于超重儿童(P值均<0.05).6~7岁儿童LVM的主要影响因素有腰臀比、臀围、性别和体脂率,其中起主要作用的是腰臀比;LVMI的主要影响因素有腰臀比、臀围、BMI和体脂率,其中起主要作用的是腰臀比.6~7岁超重、肥胖儿童罹患左心室肥大的风险未见增高.结论 超重、肥胖儿童左心室壁增厚、左心室内径增大、左心室质量增加,并且已经出现高血流动力学状态.应注意肥胖儿童腰臀比、体脂率的增加,尤其是腰臀比.
Abstract:
Objective To understand the cardiac structure and function indicators of overweight and obese children aged 6 -7 and its influencing factors,and then to provide theoretical basis for early effective intervention.Methods Part of the first grade students from five primary schools in Beijing were selected to participate in characteristic sports education program in 2014,and according to BMI diagnostic criteria,these students were divided into three groups:normal,overweight and obese.And then ultrasonic test was conducted on them to observe its change rules and influence factors.Results The detection rates of overweight and obesity of children aged 6-7 in Beijing were 18.3% and 19.7% respectively;the detection rates of the boy's overweight and obesity (10.0% and 12.0%) were higher than those of girl' s (8.3% and 7.7%),the difference was statistically significant (P<0.01);Obese children's IVSd,the IVSs,LVIDd,LVIDs,LVPWd,LVPWs,EDV,AOD,the LVM,LVMI,CO,the SV were significantly higher than those of normal children(P<0.05);Overweight children's IVSd,the IVSs,AOD,the LVM were significantly higher than those of normal children(P<0.05);Obese children' s LVIDd,EDV,the LVM,CO,the SV were all significantly higher than overweight children (P<0.05).The main influencing factors of children's LVM were the waist-to-hip ratio,hip circumference,gender and body fat rate,among which waist-to-hip ratio played the leading role;LVMI's main affecting factors were the waist-tohip ratio,hip circumference,BMI and body fat rate,and waist-to-hip ratio played the leading role.The risk of left ventricular hypertrophy was found no increase among children aged 6-7 with different types of obesity.Conclusion Overweight and obese children's left ventricular wall thickened,left ventricular inner diameter enlarged,and left ventricular mass increased,and it has appeared high hemodynamic state,especially in obese children;thus,we should pay attention to the increase of obese children' s waist hip ratio,and body fat rate,especially the waist-to-hip ratio.
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