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【medical-news】肥胖儿童的颈动脉及股动脉的超声检查

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[Ultrasonographic evaluation of atherosclerotic changes in carotid and brachial arteries in obese and hypertensive children]
[Article in Polish]

Tołwińska J, Głowińska B, Urban M, Pieciukiewicz B.

II Klinika Chorób Dzieci Akademii Medycznej w Białymstoku. klchdz2@cksr.ac.bialystok.pl

According to very well documented onset of atherosclerosis in early childhood, scientists are looking for good diagnostic methods for evaluating first changes in arterial blood vessels noninvasively. We want to know more about pathogenetic mechanisms and about changes in vessels especially in the group of young people with risk factors of premature atherosclerosis. The role of endothelial dysfunction in the very early phase of this process is known well so far. High resolution echocardiography seems to be a good method which allows to examine arteries in children and adolescents. Because of localization, brachial and carotid arteries are a very good field for this kind of examinations. The aim of this study was the evaluation with high resolution echocardiography, selected parameters of endothelial function in obese and hypertensive children and adolescents. We measured the intimal plus medial thickness in carotid common arteries (IMT) also. MATERIAL AND METHODS: We examined a group of 54 children (33 boys and 21 girls) aged 13-15 yr (mean 14 yr 6 months) obese or/ and with arterial hypertension. We eliminated persons with secondary reasons for these risk factors. For better analizes we devided a whole group into 3 subgroups: patients with isolated arterial hypertension (n-20), with isolated obesity (n-15) and with cumulation of both factors together (n-19). The control group consisted of 17 children (11 boys, 6 girls) in similar age. Using high resolution echocadiography, B-mode images, we measured during end diastole, distance "m-m" in brachial arteries (distance between two "m" lines which borde with media and adventitia of near and far wall of the artery) at rest, during reactive hyperemia (with increased flow causing endothelium-dependent dilatation FMD), again at rest and after sublingual administration glyceryl trinitrate (causing endothelium-independent dilatation NTGMD). Using Doppler technic we evaluated baseline flow and calculated degree of reactive hyperemia. We also measured intimal plus medial thickness in every carotid artery three times and calculated mean value. In our analysis we estimated concentrations of cholesterol, HDL-cholesterol, LDL-cholesterol and triglicerides. RESULTS: In the whole examined group, the vessel size was larger and FMD was significantly impaired. In the group with an isolated hypertension and isolated obesity we noticed some differences but they did not achieve statistical significance. In the group with cumulation of risk factors, the "m-m" value, was significantly higher at rest, during reactive hyperemia and after medication and FMD was significantly lower. NTGMD in all subgroups was similiar to control group. We noticed higher IMT values in the whole examined group and in the subgroups compared to the control group. The highest IMT were in the case of the cumulation of hypertension and obesity. The level of triglicerides was higher in the group of isolated obesity, with obesity and hypertension and in whole examined group against control. CONCLUSIONS: 1. FMD evaluated in brachial artery, seems to be usefull in diagnosis of impaired endothelial function in young people suffering from the risks factors of athersclerosis. 2. Isolated obesity or arterial hypertension did not influence significantly on the impairing of endothelial function. 3. The degree of impairment in endothelial function is dependent on accumulation of athersclerosis risk factors (obesity and hypertension). 4. The evaluation of IMT in carotid arteries in children with obesity and hypertension, showed more advanced degree of atherosclerotic changes in this group compared to healthy controls.

PMID: 16786745 [PubMed - indexed for MEDLINE]

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2007-12-17 17:19 浏览 : 715 回复 : 5

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本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。

2007-12-18 12:14

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[Ultrasonographic evaluation of atherosclerotic changes in carotid and brachial arteries in obese and hypertensive children]
超声检查评价肥胖和高血压儿童颈动脉及肱动脉的动脉粥样硬化改变

According to very well documented onset of atherosclerosis in early childhood, scientists are looking for good diagnostic methods for evaluating first changes in arterial blood vessels noninvasively. We want to know more about pathogenetic mechanisms and about changes in vessels especially in the group of young people with risk factors of premature atherosclerosis.
为了很好的记录儿童早期动脉粥样硬化的开始，科学家正寻找一种优秀的非侵入性的评价动脉血管最初变化的诊断方法。我们想知道更多的病因机制以及血管的变化，特别是在有过早动脉粥样硬化危险因子的年轻人群中。
The role of endothelial dysfunction in the very early phase of this process is known well so far. High resolution echocardiography seems to be a good method which allows to examine arteries in children and adolescents. Because of localization, brachial and carotid arteries are a very good field for this kind of examinations.
到目前为止内皮功能障碍在这个过程很早期阶段中的作用已被很好的了解。高分辨率超声心动图似乎是一个好的方法，因它可以检测儿童和青少年的动脉。肱动脉和颈动脉因为位置的关系是这种检查方法的很好的部位。
The aim of this study was the evaluation with high resolution echocardiography, selected parameters of endothelial function in obese and hypertensive children and adolescents. We measured the intimal plus medial thickness in carotid common arteries (IMT) also.
本研究的目的用高分辨率超声心动图在肥胖并且患有高血压的儿童青少年中选择内皮功能作为参数评价。我们同时测量颈总动脉的内膜加中膜厚度。
MATERIAL AND METHODS: We examined a group of 54 children (33 boys and 21 girls) aged 13-15 yr (mean 14 yr 6 months) obese or/ and with arterial hypertension. We eliminated persons with secondary reasons for these risk factors.
材料和方法：我们检查了一组54例儿童（男孩33个，女孩21个），他们年龄在13-15岁，肥胖或者/并且患有高血压。我们用这些危险因素的继发性原因排除入选者。
For better analizes we devided a whole group into 3 subgroups: patients with isolated arterial hypertension (n-20), with isolated obesity (n-15) and with cumulation of both factors together (n-19). The control group consisted of 17 children (11 boys, 6 girls) in similar age.
为了更好的分析，我们把整个人群分为三个亚组：只患有动脉高血压的一组（n=20），只有肥胖的一组（n=15），同时有两个因素的一组（n=19）。对照组由17个年龄相似的儿童（11个男孩，6个女孩）组成。
Using high resolution echocadiography, B-mode images, we measured during end diastole, distance "m-m" in brachial arteries (distance between two "m" lines which borde with media and adventitia of near and far wall of the artery) at rest, during reactive hyperemia (with increased flow causing endothelium-dependent dilatation FMD), again at rest and after sublingual administration glyceryl trinitrate (causing endothelium-independent dilatation NTGMD).
使用高分辨率超声心动图B型成像，我们测量静息状态下舒张末期肱动脉的“m-m”长度（指动脉近、远壁内外膜之间的分界的两条“m”线之间的距率），然后在反应性的充血状态下（血流增加引起内皮依赖性的舒张,记为FMD）测量，然后在静息含服硝酸甘油后（引起独立于内皮的舒张，记为NTGMD）测量。
Using Doppler technic we evaluated baseline flow and calculated degree of reactive hyperemia. We also measured intimal plus medial thickness in every carotid artery three times and calculated mean value. In our analysis we estimated concentrations of cholesterol, HDL-cholesterol, LDL-cholesterol and triglicerides.
我们使用多普勒技术评价基线血流并且计算反应性充血的程度。我们同时测量每一个颈动脉内膜加中膜厚度三次求平均值。在我们的分析中我们估计了胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯的浓度。
RESULTS: In the whole examined group, the vessel size was larger and FMD was significantly impaired. In the group with an isolated hypertension and isolated obesity we noticed some differences but they did not achieve statistical significance.
结果：在整个试验组，血管更大并且FMD严重受损。在单独的高血压和单独的肥胖组我们注意到一些差别，但没有统计学意义。
In the group with cumulation of risk factors, the "m-m" value, was significantly higher at rest, during reactive hyperemia and after medication and FMD was significantly lower. NTGMD in all subgroups was similiar to control group. We noticed higher IMT values in the whole examined group and in the subgroups compared to the control group.
在有两个危险因子组，在静息状态、反应性充血、用药后“m-m”值均显著增高，FMD均显著降低。NTGMD在所有的亚组均与对照组相似。我们注意到在整个实验组及各个亚组内膜加中膜厚度值均高于对照组。
The highest IMT were in the case of the cumulation of hypertension and obesity. The level of triglicerides was higher in the group of isolated obesity, with obesity and hypertension and in whole examined group against control.
最高的内膜加中膜厚度出现在合并高血压和肥胖的一个病例中。在单独肥胖组、肥胖合并高血压组及整个试验组甘油三酯水平均高于对照组。
CONCLUSIONS: 1. FMD evaluated in brachial artery, seems to be usefull in diagnosis of impaired endothelial function in young people suffering from the risks factors of athersclerosis. 2. Isolated obesity or arterial hypertension did not influence significantly on the impairing of endothelial function.
结论：1.在肱动脉评价的FMD在诊断遭受动脉粥样硬化危险因子危害的内皮功能受损方面似乎是有用的。2.单独的肥胖或者高血压病不显著影响内皮功能受损。
3. The degree of impairment in endothelial function is dependent on accumulation of athersclerosis risk factors (obesity and hypertension). 4. The evaluation of IMT in carotid arteries in children with obesity and hypertension, showed more advanced degree of atherosclerotic changes in this group compared to healthy controls.
3.内皮功能受损的程度依赖于动脉粥样硬化危险因子（肥胖、高血压）的聚集。4.在肥胖合并高血压的儿童中评价颈动脉内膜加中膜厚度，这组相对于健康对照组动脉粥样硬化进展程度更重。

整理如下（字数1037）：

超声检查评价肥胖和高血压儿童颈动脉及肱动脉的动脉粥样硬化改变

为了很好的记录儿童早期动脉粥样硬化的开始，科学家正寻找一种优秀的非侵入性的评价动脉血管最初变化的诊断方法。我们想知道更多的病因机制以及血管的变化，特别是在有过早动脉粥样硬化危险因子的年轻人群中。到目前为止内皮功能障碍在这个过程很早期阶段中的作用已被很好的了解。高分辨率超声心动图似乎是一个好的方法，因它可以检测儿童和青少年的动脉。肱动脉和颈动脉因为位置的关系是这种检查方法的很好的部位。本研究的目的用高分辨率超声心动图在肥胖并且患有高血压的儿童青少年中选择内皮功能作为参数评价。我们同时测量颈总动脉的内膜加中膜厚度。
材料和方法：我们检查了一组54例儿童（男孩33个，女孩21个），他们年龄在13-15岁，肥胖或者/并且患有高血压。我们用这些危险因素的继发性原因排除入选者。为了更好的分析，我们把整个人群分为三个亚组：只患有动脉高血压的一组（n=20），只有肥胖的一组（n=15），同时有两个因素的一组（n=19）。对照组由17个年龄相似的儿童（11个男孩，6个女孩）组成。使用高分辨率超声心动图B型成像，我们测量静息状态下舒张末期肱动脉的“m-m”长度（指动脉近、远壁内外膜之间的分界的两条“m”线之间的距率），然后在反应性的充血状态下（血流增加引起内皮依赖性的舒张,记为FMD）测量，然后在静息含服硝酸甘油后（引起独立于内皮的舒张，记为NTGMD）测量。我们使用多普勒技术评价基线血流并且计算反应性充血的程度。我们同时测量每一个颈动脉内膜加中膜厚度三次求平均值。在我们的分析中我们估计了胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯的浓度。
结果：在整个试验组，血管更大并且FMD严重受损。在单独的高血压和单独的肥胖组我们注意到一些差别，但没有统计学意义。在有两个危险因子组，在静息状态、反应性充血、用药后“m-m”值均显著增高，FMD均显著降低。NTGMD在所有的亚组均与对照组相似。我们注意到在整个实验组及各个亚组内膜加中膜厚度值均高于对照组。最高的内膜加中膜厚度出现在合并高血压和肥胖的一个病例中。在单独肥胖组、肥胖合并高血压组及整个试验组甘油三酯水平均高于对照组。
结论：1.在肱动脉评价的FMD在诊断遭受动脉粥样硬化危险因子危害的内皮功能受损方面似乎是有用的。2.单独的肥胖或者高血压病不显著影响内皮功能受损。3.内皮功能受损的程度依赖于动脉粥样硬化危险因子（肥胖、高血压）的聚集。4.在肥胖合并高血压的儿童中评价颈动脉内膜加中膜厚度，这组相对于健康对照组动脉粥样硬化进展程度更重。

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2007-12-20 08:15

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qcywh2000

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According to very well documented onset of atherosclerosis in early childhood, scientists are looking for good diagnostic methods for evaluating first changes in arterial blood vessels noninvasively. We want to know more about pathogenetic mechanisms and about changes in vessels especially in the group of young people with risk factors of premature atherosclerosis.
为了很好的记录儿童早期动脉粥样硬化的开始，科学家正寻找一种优秀的非侵入性的评价动脉血管最初变化的诊断方法。我们想知道更多的病因机制以及血管的变化，特别是在有过早动脉粥样硬化危险因子的年轻人群中。
According to的意思应该是“根据”，并不是说研究的目的。
第一句译为，基于儿童早期动脉粥样硬化发病的大量资料（well documented想不出好的译法）
premature atherosclerosis 动脉粥样硬化前期

The role of endothelial dysfunction in the very early phase of this process is known well so far.
到目前为止内皮功能障碍在这个过程很早期阶段中的作用已被很好的了解。
迄今为止，动脉粥样硬化的极早期阶段中内皮功能障碍的作用已广为人知。
或，迄今为止，研究人员已充分了解动脉粥样硬化的极早期阶段中内皮功能障碍的作用。

The aim of this study was the evaluation with high resolution echocardiography, selected parameters of endothelial function in obese and hypertensive children and adolescents.
本研究的目的用高分辨率超声心动图在肥胖并且患有高血压的儿童青少年中选择内皮功能作为参数评价。
本研究的目的是，应用高分辨率超声心动图及内皮功能的选择性参数评价肥胖并且患有高血压的儿童青少年。

MATERIAL AND METHODS: We examined a group of 54 children (33 boys and 21 girls) aged 13-15 yr (mean 14 yr 6 months) obese or/ and with arterial hypertension. We eliminated persons with secondary reasons for these risk factors.
材料和方法：我们检查了一组54例儿童（男孩33个，女孩21个），他们年龄在13-15岁，肥胖或者/并且患有高血压。我们用这些危险因素的继发性原因排除入选者。
arterial hypertension动脉压过高
材料及方法：我们检查了54例儿童（男33，女21），年龄13-15岁（平均14岁6个月），肥胖或/及高动脉压。排除继发性患者。

In our analysis we estimated concentrations of cholesterol, HDL-cholesterol, LDL-cholesterol and triglicerides.
在我们的分析中我们估计了胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯的浓度。
Estimated译为“评价”稍好，毕竟是客观实验室数据，“估计”欠妥。

CONCLUSIONS: 1. FMD evaluated in brachial artery, seems to be usefull in diagnosis of impaired endothelial function in young people suffering from the risks factors of atherosclerosis. 2. Isolated obesity or arterial hypertension did not influence significantly on the impairing of endothelial function.
结论：1.在肱动脉评价的FMD在诊断遭受动脉粥样硬化危险因子危害的内皮功能受损方面似乎是有用的。2.单独的肥胖或者高血压病不显著影响内皮功能受损。
1．对有动脉粥样硬化危险因子的年轻人来说，测量肱动脉FMD有助于诊断内皮功能受损。
2．单独的肥胖或者高血压病对内皮功能受损无显著影响。

3. The degree of impairment in endothelial function is dependent on accumulation of atherosclerosis risk factors (obesity and hypertension). 4. The evaluation of IMT in carotid arteries in children with obesity and hypertension, showed more advanced degree of atherosclerotic changes in this group compared to healthy controls.
3.内皮功能受损的程度依赖于动脉粥样硬化危险因子（肥胖、高血压）的聚集。4.在肥胖合并高血压的儿童中评价颈动脉内膜加中膜厚度，这组相对于健康对照组动脉粥样硬化进展程度更重。
3. 内皮功能受损程度依赖于动脉粥样硬化危险因子（肥胖、高血压）的累积。
4. 相对于健康对照组，肥胖合并高血压儿童组患者的颈动脉内膜加中膜厚度表明动脉粥样硬化进展程度更重。

2007-12-20 09:52

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qcywh2000 编辑于 2007-12-20 09:56

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