肥胖儿童血管内皮运动功能障碍及其对左心结构和血压的影响

A RESEARCH ON VASCULAR ENDOTHELIAL DYSFUNCTION AND ITS EFFECT ON LEFT VENTRICULAR STRUCTURE AND BLOOD PRESSURE IN SIMPLE OBESE CHILDREN

目的 :观察肥胖儿童早期血管内皮功能改变及其对左心结构和血压的影响。方法 :学龄期单纯性肥胖儿童及正常对照儿童各 4 0例 ,分别测定血浆内皮素 (ET)、6 酮前列环素 (6 k PGF1α)和血清一氧化氮 (NO)水平。采用多普勒超声观察增加血流介导的血管舒张 (FMD) ,用二维超声心动图测量左室内径、室间隔与左室后壁厚度和左室心肌重量指数 (LVMI) ,用标准袖带法测量收缩血压 (SBP)和舒张血压 (DBP)。结果 :肥胖儿童ET、LVMI、SBP和DBP均升高 ,而NO、6 k PGF1α和FMD均明显降低。FMD与NO和 6 k PGF1α呈显著正相关 ,而与ET、LVMI、SBP和DBP均呈负相关。结论 :肥胖儿童内皮源性血管收缩因子分泌增加 ,舒张因子分泌减少 ,内皮依赖性血管舒张功能下降 。

Objective:To observe vascular endothelial dysfunction and its effect on left ventricular structure and blood pressure in early stage of obese children. Methods:The study involved 40 simple obese school age children and 40 healthy children selected by paired investigation as the control group. Plasma ET and 6 k PGF 1α and serum NO Ievels were assayed,respectively.The flow mediated dilation (FMD) of brachialis ateria was measrued by Doppler ultrasound. Then left ventricular anatomic indexes were determined with echocardiogram, and blood pressure,with standard measurement. Results:The levels of NO and 6 k PGF 1α and FMD were evidently lower,while ET level,LVMI,SBP and DBP higher in obese children. FMD was correlated positively with NO and 6 k PGF 1α ,but negatively with ET,LVMI,SBP and DBP. Conclusion:In obese children there are disorder of endothelium derived factors and dysfunction of endothelium dependent relaxation,which lead to hypertension and left ventricular hypertrophy.