青春期肥胖超重儿大、中动脉内中膜及血流动力学变化的超声研究

Ultrasonic Study on the Changes of Intimal-Medial Thickness and Hemodynamics in Large-and Medium-Sized Arteries of the Obese and Overweight Pubescent Children

目的 分析青春期肥胖儿颈总动脉、足背动脉内中膜厚度,血流动力学变化与BMI指数之间的关系.方法 采用彩色多普勒超声分别测量40名肥胖青少年、37名超重青少年和42名正常体重青少年颈总、足背动脉内径、内中膜厚度（intimal-medial thickness,IMT）及血流动力学指标.生化分析法检测空腹血糖、空腹胰岛素,计算胰岛素抵抗指数.结果 与体重正常组相比,肥胖组和超重组的BMI、颈总及足背动脉IMT、空腹血糖（FBS）、空腹胰岛素（FINS）、胰岛素抵抗指数（IR）均明显升高,差异有显著性（P〈0.05）.足背动脉反应性充血前后血管内径变化百分率肥胖、超重组较正常对照组降低,差异有显著性（P〈0.05）.结论 肥胖超重组青少年普遍存在胰岛素抵抗;肥胖超重组青少年的颈总、足背动脉的内中膜厚度及血流动力学改变与肥胖程度有关,提示肥胖超重组青少年的血管内皮功能受损.

Objective To analyze the relationship between body mass index（BMI）,intimal-medial thickness（IMT） and hemodynamics of the common carotid artery and dorsal pedal artery in the obese and overweight pubescent children. Methods Color Doppler ultrasound was used to measure the internal diameter, intimal-medial thickness in the common carotid and dorsal pedal artery, the peak systolic velocity, dorsal pedal artery contract and diastole compliance were measured respectively in 40 obese,37 overweight,42 normal children.The levels of free glucose and insulin were detected.Insulin resistance index（IR） were measured. Results IMT of the common carotid and dorsal pedal artery, free glucose and insulin,IR in the obese and overweight pubescent children were significantly higher than those in the normal children（P〈0.05）.The changes of inner diameter of dorsal pedal artery were significantly lower than those in the normal children（P〈0.05）. Conclusions These results indicated that insulin resistance was universal existence in obese and overweight children.The changes of IMT, inner diameter and the hemodynamics of the dorsal pedal artery were correlated with the obesity degree,and suggested that vascular endothelial function was damaged in the obese and overweight pubescent children.