颈动脉超声技术与儿童临床前动脉粥样硬化危险因素  

Carotid Ultrasound Technique and the Risk Factors for Pre-clinical Atherosclerosis in Children

作　　者：刘颖[1] 张玉林[2] 王峥嵘[2] 唐朝枢[3] 杜军保[1] 

机构地区：[1]北京大学第一医院儿科,北京市100034 [2]首都儿科研究所附属儿童医院B超科,北京市100020 [3]国家教育部分子心血管病重点实验室,北京市100034

出　　处：《中国动脉硬化杂志》2006年第12期1041-1044,共4页Chinese Journal of Arteriosclerosis

基　　金：北京市科技计划项目(H030930030530;H030930030031)

摘　　要：目的应用双功能彩色多普勒超声诊断仪检测儿童颈动脉内膜中膜厚度，找寻与临床前动脉粥样硬化发病相关的危险因素。方法选择5～17岁儿童79倒，利用超声技术定量评价其颈动脉内膜中膜厚度及心脏结构和功能，应用日立7060型全自动生物化学分析仪检测其空腹血浆总胆固醇、甘油三酯、高密度脂蛋白及低密度脂蛋白含量，计算动脉粥样硬化指数。对其进行体格检查并测量身高、体重及血压，计算体质指数以反映身体肥胖程度；详细询）＇--I高血压、冠心病、肥胖及血脂紊乱家族史。通过蝴鲥c回归分析进一步分析这些指标与颈动脉内膜中膜厚度的相关性。结果具有高血压、肥胖及血脂紊乱阳性家族史的儿童颈动脉内膜中膜厚度较阴性家族史儿童明显增厚（χ^2=4．364，P〈0．05）；多元Logistic回归方程表明，颈动脉内膜中膜厚度与舒张压及动脉粥样硬化指数存在一定的定量关系。结论对于动脉粥样硬化高危儿童应定期B超监测颈动脉内膜中膜厚度，并针对相对危险因素予以预防。Aim To discuss carotid intimal-media thickness in children using B-mode ultrasound and look for the risk factors of pre-clinical atherosclerosis. Methods Carotid intimal-media thickness was detected in seventy-nine children aged from 5 to 17 yeats old by using B-mode ultrasound. And cardiac structure and function were measured by color Doppler ultrasound. Trial plasma cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol were detected by HITACHI 7600 automatic biochemical analyzer. Atherogenic index was calcculated as LDLC/HDLC. Physical examination was carded on. Blood pressure was measured. Body mass index was calculated according to body height and weight. Familial history of hypertension, coronary heart disease, obesity and dyslipidemia were investigated. The relationship between carotid infimal-media thickness and indexes above was analyzed by Logistic regression. Results There was a difference between the measurements of carotid intimal-media thickness on children with positive and negative histories of obesity, dyslipidemia and hypertension （ χ^2 = 4.364, P 〈 0. 05 ）. The multiple Logistic regression equation indicated that there were quantitative relationship between carotid intimal-media thickness and diastolic blood pressure and atherogenie index. Conclusions Carotid intimal-media thickness monitoring should be carried on if children had high risk factors of atherosclerosis for better prevention and intervention.

关 键 词：病理学与病理生理学 颈动脉内膜中膜厚度 儿童 动脉粥样硬化 血脂紊乱 B型超声 肥胖 高血压 

分 类 号：R363[医药卫生—病理学]