全息血管硬度分析技术评价重度中心性肥胖儿童内脏脂肪分布与颈动脉弹性功能的相关性  

Correlation of visceral fat distribution and carotid artery elasticity in severely abdominal obese children by RF-data based quantitative analysis on vessel stiffness

作　　者：吴铭 徐雪艳 牛瑜琳 张喜君 袁建军 王振华 陈永兴 陈琼[3] 卫海燕[3] 朱好辉 Wu Ming;Xu Xueyan;Niu Yulin;Zhang Xijun;Yuan Jianjun;Wang Zhenhua;Chen Yongxing;Chen Qiong;Wei Haiyan;Zhu Haohui(Department of Ultrasound,Henan University People's Hospital&Henan Provincial People's Hospital&Zhengzhou University People's Hospital,Zhengzhou 450003,China;Department of Ultrasound,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China;Department of Endocrinology and Inherited Metabolic Disease,Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南大学人民医院,河南省人民医院,郑州大学人民医院超声科,450003 [2]郑州大学附属洛阳中心医院超声科,471000 [3]郑州大学附属儿童医院(河南省儿童医院)内分泌遗传代谢科,450000

出　　处：《中华超声影像学杂志》2020年第8期662-667,共6页Chinese Journal of Ultrasonography

基　　金：河南省科技攻关计划(国际科技合作)项目(172102410014);中国超声医师科技新星计划项目(KJXX2019006)。

摘　　要：目的:应用全息血管硬度分析(R-VQS)技术评价重度中心性肥胖儿童颈动脉弹性功能,分析其内脏脂肪分布与颈动脉弹性的相关性。方法:选取2018年7月至2019年7月在郑州大学附属儿童医院就诊的7~14岁重度中心性肥胖儿童70例,另选取55例体质指数正常的健康儿童作为对照组。采用超声测量心外膜脂肪厚度(EFT)、腹部内脏脂肪厚度(VFT)、腹部皮下脂肪厚度(SFT)、腹膜前最大脂肪厚度(PFTmax)、肝前皮下脂肪厚度(SFTmin)、肾周脂肪厚度(PRFT),采用全息血管内-中膜厚度测量(RIMT)和R-VQS技术测量颈总动脉内中-膜厚度(IMT)以及弹性指标血管收缩期管径(Diam)、管径变化值(Dist)、脉搏波传导速度(PWV)和硬度指数(HC)。比较两组间各参数的差异性,并分析肥胖儿童各部位脂肪厚度与颈动脉弹性指标的相关性。结果:与对照组比较,肥胖组颈动脉IMT、Diam、PWV、HC及EFT、VFT、SFT、PFTmax、SFTmin、PRFT升高,颈动脉Dist降低,差异有统计学意义(均P<0.05)。肥胖组PFTmax、VFT、EFT、PRFT与颈动脉IMT、PWV、HC均呈正相关(与IMT:r=0.334、0.425、0.415、0.370,P<0.05;与PWV:r=0.853、0.744、0.590、0.358,P<0.05;与HC:r=0.822、0.691、0.526、0.320,P<0.05),SFT、SFTmin与颈动脉IMT、PWV、HC均无明显相关性(P>0.05)。内脏脂肪厚度与颈动脉弹性参数的相关性程度为PFTmax>VFT>EFT>PRFT,但EFT和PRFT与颈动脉弹性参数的相关性较弱(r<0.7)。结论:R-VQS技术可以较敏感地反映重度中心性肥胖儿童颈动脉弹性功能,可作为早期评估肥胖儿童动脉粥样硬化程度的重要参考指标;肥胖儿童的内脏脂肪厚度PFTmax、VFT、EFT、PRFT与颈动脉弹性变化呈正相关,其中PFTmax与颈动脉弹性参数相关性最好,对于肥胖儿童的治疗随访具有一定的临床意义。Objective To evaluate the carotid artery elasticity in severely abdominal obese children by RF-data based quantitative analysis on vessel stiffness(R-VQS),and explore the correlation between visceral fat distribution and carotid artery elasticity.Methods Seventy severely abdominal obese children aged 7-14 years old and 55 healthy children with normal body mass index were selected as obese group and control group in Children's Hospital Affiliated to Zhengzhou University from July 2018 to July 2019.Epicardial fat thickness(EFT),visceral fat thickness(VFT),subcutaneous fat thickness(SFT),maximum preperitoneal fat thickness(PFTmax),minimum subcutaneous fat thickness(SFTmin),perirenal fat thickness(PRFT)were measured by ultrasound.Real-time intima-media thickness(RIMT)and R-VQS were employed to evaluate common carotid intima-media thickness(IMT),systolic diameter(Diam),distance(Dist),pulse wave velocity(PWV)and hardness coefficient(HC).The correlation between fat thickness and carotid artery elasticity was analyzed.Results There were statistically differences of common carotid IMT,elasticity parameters(IMT,Diam,Dist,PWV,HC)and fat thickness(EFT,VFT,SFT,PFTmax,SFTmin,PRFT)between two groups(P<0.05).In obese children,PFTmax,VFT,EFT,PRFT were positively correlated with IMT,PWV,and HC(with IMT:r=0.334,0.425,0.415,0.370,P<0.05;with PWV:r=0.853,0.744,0.590,0.358,P<0.05;with HC:r=0.822,0.691,0.526,0.320,P<0.05),and there was no correlation between SFT,SFTmin and IMT,PWV,HC(P>0.05).The degree of correlations between visceral fat thickness and carotid artery elasticity was PFTmax>VFT>EFT>PRFT,however,the correlations between EFT,PRFT and carotid elastic elasticity were weak(r<0.7).Conclusions R-VQS can sensitively reflect the carotid artery elasticity in severely abdominal obese children,and it can be used as an important reference indicator for early evaluation of atherosclerosis in obese children.Their visceral fat thickness(EFT,PRFT,VFT and PFTmax)have a good correlation with carotid artery elasticity,among which PFTmax has

关 键 词：超声检查 全息血管硬度分析技术 肥胖儿童 内脏脂肪厚度 颈动脉弹性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R723.14[医药卫生—诊断学]