發(fā)布時(shí)間：2018-07-06 16:48

  本文選題：兒童 + 肥胖癥�。� 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:運(yùn)用三維斑點(diǎn)追蹤技術(shù)定量分析肥胖癥兒童左心室收縮功能的變化,并探討其與血清C反應(yīng)蛋白水平變化的關(guān)系,幫助臨床評估肥胖癥兒童心血管疾病的風(fēng)險(xiǎn),為它們的早期臨床干預(yù)提供依據(jù)。方法:選取7-15歲的肥胖兒童55例為肥胖組,超重兒童39例為超重組,并選取年齡、性別相匹配的正常體重兒童44例為對照組。研究對象均接受常規(guī)二維超聲心動圖檢查,測量左室舒張末期、收縮末期內(nèi)徑(LVEDD、LVESD),左室舒張末期容積和收縮末期容積(LVEDV、LVESV),左室射血分?jǐn)?shù)(LVEF),舒張末期室間隔厚度和左室后壁厚度(IVST、LVPWT),計(jì)算左室相對室壁厚度(RWT)。應(yīng)用Tom-tec工作站中的三維斑點(diǎn)分析軟件分析三維全容積動態(tài)圖,自動計(jì)算出左室整體徑向應(yīng)變(GRS)、縱向應(yīng)變(GLS)、圓周應(yīng)變(GCS)及扭轉(zhuǎn)角度(GTA)、左室質(zhì)量(LVM)。所有研究對象均采集空腹晨血5ml離心后應(yīng)用特定蛋白分析系統(tǒng)檢測血清C反應(yīng)蛋白(CRP)水平。比較肥胖、超重、正常組之間左室收縮功能等相關(guān)指標(biāo)及血清CRP水平的差異,并分析CRP與它們之間的相關(guān)性。結(jié)果:1)肥胖組兒童較對照組兒童IVST、LVPWT、RWT增加,有顯著性差異(P0.05);較超重組兒童IVST、LVPWT、RWT增加,有顯著性差異(P0.05)。2)肥胖組兒童較對照組兒童GRS、GLS、GCS、GTA減低,LVM增加,有顯著性差異(P0.05);超重組兒童較對照組兒童GRS、GLS、GCS減低,有顯著性差異(P0.05)。3)肥胖組兒童較超重組、對照組兒童血清CRP水平均明顯升高,有顯著性差異(P0.05);超重組兒童血清CRP較對照組兒童明顯升高,有顯著性差異(P0.05)。血清CRP水平與BMI呈顯著正相關(guān)(r=0.59,P0.05)。4)血清CRP水平與GRS、GLS、GCS呈一定的負(fù)相關(guān)性(r=-0.41,P0.05;r=-0.36,P0.05;r=-0.40,P0.05);CRP水平與RWT、LVM呈一定的正相關(guān)性(r=0.29,P0.05;r=0.29,P0.05)。結(jié)論:1)兒童在向肥胖發(fā)展的早期其左心室收縮功能就已出現(xiàn)受損。2)在兒童肥胖早期,血清C反應(yīng)蛋白水平已明顯升高,且與左心室功能受損有著密切聯(lián)系。3)三維斑點(diǎn)追蹤技術(shù)可對肥胖癥兒童左室心肌功能進(jìn)行定量分析,且較常規(guī)二維超聲心動圖更敏感、精確地檢測出心肌功能的早期改變。
[Abstract]:Objective: to study the relationship between the changes of left ventricular systolic function and serum C-reactive protein (CRP) levels in obese children by using three-dimensional speckle tracing technique to evaluate the risk of cardiovascular disease in obese children. To provide basis for their early clinical intervention. Methods: 55 obese children aged 7-15 years were selected as obese group, 39 overweight children as superrecombinant group, and 44 normal weight children of age and sex matched as control group. All subjects were examined by conventional two-dimensional echocardiography to measure left ventricular end-diastolic function. Left ventricular relative wall thickness (RWT), left ventricular end-diastolic volume and end-systolic volume (LVEDVV / LVESV), left ventricular ejection fraction (LVEF), left ventricular septal thickness and left ventricular posterior wall thickness (IVST-LVPWT) were calculated by endsystolic diameter (LVEDDD), left ventricular end-diastolic volume (LVESD), left ventricular end-diastolic volume (LVESV), left ventricular ejection fraction (LVEF) and left ventricular posterior wall thickness (IVST-LVPWT). Using the software of 3D speckle analysis in Tom-tec workstation to analyze three-dimensional full-volume dynamic images, the global radial strain (GRS), longitudinal strain (GLS), circumferential strain (GCS), torsion angle (GTA) and left ventricular mass (LVM) were calculated automatically. Serum C-reactive protein (C-reactive protein) levels were measured by specific protein analysis system after fasting morning blood 5ml centrifugation. The relative indexes of left ventricular systolic function and serum CRP were compared between obese, overweight and normal group, and the correlation between CRP and CRP was analyzed. Results the RWT of the obese children was significantly higher than that of the control group (P0.05), and the RWT of IVST-LVPWT-RWT was significantly higher than that of the control group (P0.05), and the RWT of the obese children was significantly higher than that of the control group (P0.05). The increase of LVM in obese children was lower than that in the control group (P0.05). There was significant difference (P0.05); GRSS-GLSN GCS in overweight children was lower than that in control group (P0.05). The serum CRP level in obese children was significantly higher than that in control group. There was significant difference (P0.05); the serum CRP of superrecombinant children was significantly higher than that of the control group (P0.05). There was a positive correlation between serum CRP level and BMI (r 0.59% P0.05). There was a certain negative correlation between serum CRP level and GRSs GLSN GCS (r-0.41% P 0.05 P 0.05 P 0.05 r-0.40 P 0.05). There was a certain positive correlation between CRP level and RWTLVM (r 0.29 P 0.05 P 0.05 P 0.29 P 0. 29 P 0. 29 P 0. 05 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29 P 0. 29). Conclusion: (1) at the early stage of obesity, the left ventricular systolic function of children has been impaired by .2) at the early stage of childhood obesity, the level of serum C-reactive protein has been significantly increased. 3) Three-dimensional speckle tracing technique can be used to quantitatively analyze left ventricular function in obese children. It is more sensitive than conventional two-dimensional echocardiography and can accurately detect the early changes of myocardial function.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R723.14;R540.45

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