儿童代谢综合征血清高敏C反应蛋白水平变化及其与心血管疾病危险因素的关系

Change of serum high- sensitive C-reactive protein and its relationship with risk factors of cardiovascular diseases in children with metabolic syndrome

目的：通过观察儿童代谢综合征（MetabolicSyndrome，Ms）血清高敏C反应蛋白（hs—CRP）水平的变化，探讨hs—CRP与儿童心血管疾病危险因素的关系及其在临床的应用和价值。方法：选取2012年8月～2013年8月就诊于大连医科大学附属第一医院儿科门诊及住院部的肥胖儿童及青少年129例，其中MS患儿22例（MS组）、肥胖儿童107例（非MS组），另设健康体检儿童30例作为对照组，于清晨空腹测量身高、体重、腰围（WC）及血压；抽取静脉血测定空腹血糖、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）及hs—CRP水平。结果：与对照组相比，非MS组及Ms组hs—CRP显著增高，且Ms组hs—CRP高于非MS组；Spearman相关分析结果显示：hs—CRP水平与体质指数、WC、TC、TG、LDL—C、血糖、收缩压（SBP）及舒张压（DBP）呈正相关（r=0．59，P〈0．05；r=0．54，P〈0．05；r=0．35，P〈0．05；r=0．50，P〈0．05；r=0．24，P〈0．05；r=0．21，P〈0．05；r=0．34，P〈0．05；r=0．25，P〈0．05），与HDL—C呈负相关（r=-0．19，P〈0．05）。结论：hs—CRP与心血管危险因素具有相关性，hs—CRP可作为评估及预测MS及单纯性肥胖儿童发生心血管疾病风险因素的指标之一。

Objective： To explore the relationship between high - sensitive C - reactive protein （ hs - CRP） and risk factors of car- diovascular diseases and the application and value of hs - CRP in clinic by observing the change of serum hs - CRP in children with metabol- ic syndrome （MS） . Methods： A total of 129 obese children and adolescents from pediatric outpatient department and inpatient department of the hospital from August 2012 to August 2013 were selected and divided into MS group （22 children） and non- MS group （107 chil- dren） ; 30 children receiving healthy physical examination in the hospital during the same period were selected as control group. Fasting body height, body weight, waist circumference （WC） and blood pressure were measured; venous blood samples were obtained to detect fasting blood glucose, total cholesterol （TC）, triglyceride （TG）, high- density lipoprotein cholesterol （HDL- C）, low- density lipoprotein cho- lesterol （ LDL - C ） and hs - CRP levels. Results： Compared with control group, hs - CRP levels in non - MS group and MS group in- creased significantly, and hs -CRP level in MS group was higher than that in non - MS group; the results of Spearman correlation analysis showed that hs -CRP level was positively correlated with body mass index （BMI） , WC, TC, TG and LDL- C levels, blood glucose level, systolic blood pressure （SBP） and diastolic blood pressure （DBP） （ r = 0. 59, P 〈 0. 05 ; r = 0. 54, P 〈 0.05 ; r = 0. 35, P 〈 0. 05 ; r = 0. 50, P 〈 O. 05 ; r = 0. 24, P 〈 O. 05 ; r = 0. 21, P 〈 0.05 ; r = 0. 34, P 〈 O. 05 ; r = 0. 25, P 〈 0.05 ）, hs - CRP level was negatively corre- lated with HDL - C level （r =0. 19, P 〈0. 05） . Conclusion： There is a correlation between hs - CRP and risk factors of cardiovascular diseases, hs - CRP can be used as a indicator of evaluation and prediction of risk factors of cardiovascular diseases in MS and simple obese children.