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目的探讨单纯性肥胖儿童血浆血管紧张素II、醛固酮变化对心脏结构的影响,为预防单纯性肥胖儿童发生心血管病疾患的方法提供理论依据。方法分别测量30例单纯性肥胖儿童和30例对照组儿童的体重指数(BMI),并采用彩色超声仪测量左室质量(LVM),同时测定血浆血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)浓度。结果①肥胖组AngⅡ,ALD均显著高于对照组(P<0.05),两组差异有统计学意义,说明血管紧张素醛固酮系统在儿童肥胖中的作用。②肥胖组LVM显著高于对照组,室间隔厚度(IVST),左室舒张末期内径(LVIDd),左室后壁厚度(LVPWT),LVM肥胖组分别为6.3±0.8,49.1±3.1,6.8±1.1,107.8±27.0;对照组为5.7±0.4,43.4±2.1,6.2±0.4,76.1±12.0,P值均<0.01。③肥胖组中AngⅡ,ALD均与LVM之间存在直线正相关和回归关系。回归系数t检验P均<0.05,AngⅡ,ALD浓度升高在引起LVM增加中起作用。结论肥胖组儿童存在的肾素-血管紧张素-醛固酮系统(RAAS)异常激活在引起其心肌肥厚中起作用。ALD与AngⅡ相互作用,增强了RAAS的活性,促进心肌肥厚的进一步发展。
Objective To investigate the effects of plasma angiotensin II and aldosterone on cardiac structure in simple obese children and provide a theoretical basis for prevention of cardiovascular disease in simple obesity children. Methods The body mass index (BMI) of 30 children with obesity and 30 children with chronic obstructive pulmonary disease were measured. The left ventricular mass (LVM) was measured by color sonography, and the levels of plasma angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) concentration. Results ① Ang Ⅱ and ALD in obese group were significantly higher than those in control group (P <0.05). The difference between the two groups was statistically significant, indicating the role of angiotensin aldosterone system in childhood obesity. (2) The LVM in obesity group was significantly higher than that in control group. The differences of IVST, LVIDd, LVPWT and LVM obesity were 6.3 ± 0.8, 49.1 ± 3.1 and 6.8 ± 1.1, 107.8 ± 27.0 in the control group, 5.7 ± 0.4, 43.4 ± 2.1, 6.2 ± 0.4, 76.1 ± 12.0 in the control group, P <0.01 respectively. There was a linear positive correlation and regression between AngⅡ, ALD and LVM in obesity group. Regression coefficient t test P <0.05, Ang ¢ ò, elevated ALD concentrations in the role in causing increased LVM. Conclusion Abnormal activation of renin-angiotensin-aldosterone system (RAAS) in obese children may play a role in the induction of cardiac hypertrophy. ALD and Ang Ⅱ interaction, enhance the activity of RAAS, and promote further development of cardiac hypertrophy.