单纯性肥胖儿童颈动脉的超声研究

B-mode and Doppler ultrasonography of carotid artery in obese children

目的:应用二维及多普勒超声,定量单纯性肥胖儿童颈动脉的结构和血流及其临床意义。方法:对60例肥胖儿童(脂肪肝组30例,非脂肪肝组30例)和30名正常儿童进行二维超声测量颈总动脉(CCA)的内径(d)和内膜厚度(IMT),以及颈内动脉(ICA)、颈外动脉(ECA)及椎动脉(VA)内径;多普勒超声测量峰值流速(Vs)、舒张期流速(Vd)、平均流速(Vm)、阻力指数(RI)和峰值流速与舒张末期流速的比值(S/D)。结果:①肥胖儿童的CCA IMT比对照组明显增高,差异有统计学意义(P<0.05)。受检者IMT与体质量指数(BMI)呈线性正相关,r=0.60,P<0.01。②肥胖儿童的血流速度(CCA-Vs、ICA-Vd、ECA-Vd)与正常对照组比较均明显减低(P<0.05),而血管阻力(ICA-RI、ECA-RI、ECA-S/D)明显增高(P<0.05),差异均有统计学意义;其中脂肪肝组部分颈动脉血流速度(CCA-Vm、ECA-Vs、ECA-Vm、VA-Vs)与正常对照组比较均明显减低,差异有统计学意义(P<0.05)。结论:单纯性肥胖儿童存在颈动脉的结构及血流动力学变化,超声对定量检测血管功能的损伤有重要临床意义。

Objective： To study the structure and blood flow of carotid artery in children with simple obesity by B-mode and Doppler ultrasound. Methods： The diameter（d） of common carotid artery（CCA）, internal carotid artery（ICA）, exterual carotid artery（ECA） and vertebral artery（VA）, and intimal-medial thickness（IMT） of CCA were measured in 60 obese children and 30 normal children in the control group by B-dimensional ultrasound. Systolic peak velocity（Vs）, diastolic velocity（Vd）, mean flow velocity（Vm）, RI and S/D were measured by Doppler ultrasound. Results： ①The IMT of CCA in obese group was significantly higher than those of the control group, but there was no difference between the fatty liver group and nonfatty liver group （P 〉 0.05）. There was a positive linear correlation between IMT and BMI. ②CCA-Vs, ICA-Vd and ECA-Vd in obesity group were significantly lower than those in the control group, and carotid resistance （ICA-RI, ECA-RI, ECA-S/D） was higher in obseity than that of the control group （P〈0.05）. Conclusion： Carotid structure and blood flow are changed in obese children. Ultrasound technology can evaluate the characteristics in obese children.