超重/肥胖儿童颈总动脉内径、血流速度和内膜中层厚度与早期动脉硬化的关系

Relationship between common carotid artery diameter,blood flow velocity,intima-media thickness and early arteriosclerosis in children with overweight/obesity

目的:探究超重/肥胖儿童颈总动脉(CCA)内径、血流速度和内膜中层厚度(IMT)与早期动脉硬化的关系。方法:根据儿童肥胖评判标准和体重指数(BMI)对120例儿童分组,BMI超过年龄标准的为观察组(n=61),BMI未超过年龄标准的为对照组(n=59)。利用动脉硬化检测仪检测臂踝脉搏波传播速度(ba PWV)。采用体表超声分别测量颈总动脉内径、血流速度[收缩期峰值血流速(PSV)和舒张末血流速(EDV)]和内膜中层厚度(IMT),并分析其与早期动脉硬化的关系。结果:对照组ba PWV值和早期动脉硬化发生率明显低于观察组(P <0. 001);两组CCA内径比较差异无统计学意义(P=0. 097),观察组PSV、EDV低于对照组,IMT高于对照组(P均<0. 05);不同超重/肥胖患儿之间早期动脉硬化发生率和IMT差异有统计学意义(P均<0. 05),随着患儿肥胖程度增加,早期动脉硬化发生率和IMT随之增加(P均<0. 05); PSV、EDV变慢(OR=1. 960和2. 040,95%CI=1. 037～3. 706和0. 810～5. 137)和IMT增厚(OR=2. 601,95%CI=1. 042～6. 497)是影响超重/肥胖儿童早期动脉硬化的独立危险因素。结论:超重/肥胖儿童ba PWV、PSV、EDV和IMT明显异于健康儿童,血流速度变慢和IMT增厚是影响超重/肥胖儿童早期动脉硬化的独立危险因素。

Aim: To determine the relationship between common carotid arterial( CCA) diameter,blood flow velocity,intima-media thickness( IMT) and with early arteriosclerosis in children with overweight/obesity. Methods: A total of 120children were classified according to the criteria for judging childhood obesity and body mass index( BMI). The children with BMI exceeding the age standard were selected as observation group( n = 61),and the left were included in control group( n = 59). The CCA diameter,blood flow velocity [peak systolic velocity( PSV) and end-diastolic velocity( EDV) ]and intima-media thickness( IMT) were measured by body surface ultrasonic method,and their correlation with early arteriosclerosis was analyzed. Results: The brachial-ankle pulse wave velocity( baP WV) value in control group was significantly lower than that in observation group( P < 0. 001). There was no significant difference in the CCA diameter between the two groups( P = 0. 097),while the values of PSV and EDV were lower and the value of IMT was higher in observation group than those in control group( P < 0. 05). With the increase of obesity degree,the incidence of arteriosclerosis and IMT were increased( P < 0. 05). Slow PSV and EDV( OR = 1. 960 and 2. 040,95% CI = 1. 037-3. 706 and 0. 810-5. 137) and IMT thickening( OR = 2. 601,95% CI = 1. 042-6. 497) were independent risk factors for early arteriosclerosis in children with overweight/obesity. Conclusion: baP WV,PSV,EDV and IMT in children with overweight/obesity are significantly different from those of healthy children. Slow blood flow velocity and IMT thickening are independent risk factors for early arteriosclerosis in overweight/obese children.