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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 ,进而导致血压升高和左心室肥厚
OBJECTIVE: To observe the changes of vascular endothelial function in early obese children and its effect on left ventricular structure and blood pressure. Methods: 40 cases of simple obesity children and normal control children were randomly divided into four groups: ET, 6K PGF1α and NO. Doppler ultrasound was used to increase blood flow-mediated vasodilation (FMD). Left ventricular diameter, left ventricular posterior wall thickness and left ventricular wall thickness were measured by two-dimensional echocardiography and left ventricular myocardial mass index (LVMI) Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by banding. Results: The levels of ET, LVMI, SBP and DBP in obese children increased, while NO, 6 k PGF1α and FMD decreased significantly. FMD was positively correlated with NO and 6 k PGF1α, but negatively correlated with ET, LVMI, SBP and DBP. CONCLUSION: Obese children have increased secretion of endothelium-derived vasoconstrictors, reduced secretion of diastolic factors and decreased endothelium-dependent vasodilation, leading to elevated blood pressure and left ventricular hypertrophy