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[儿童左心室质量与体表面积的关系]

[Left ventricular mass in children in relation to body surface area].

作者信息

Szewczykowska Mirosława, Grygalewicz Jacek, Szkiłładź-Skiba Magdalena

机构信息

Kliniczny Oddział Dzieciecy Szpital Bielański, ul. Cegłowska 80, 01-809 Warszawa.

出版信息

Med Wieku Rozwoj. 2009 Jul-Sep;13(3):187-93.

Abstract

BACKGROUND

In spite of growing interest in the problem of left ventricular hypertrophy in children there is relatively little published data on normal values of the left ventricular mass (LVM) among data on normal values in the developmental age.

AIM

To determine the normal values of LVM in infants and children in relation to body surface area (BSA), age (in months) and gender.

MATERIAL AND METHODS

This study was carried out on 773 children (403 girls and 370 boys, aged from 2 weeks to 18 yrs). They were referred for echocardiographic investigations from paediatric and neonatal hospital departments, from outpatients clinics and primary schools. In all patients cardiovascular disease was excluded. LVM (in grams) was calculated in relation to BSA, age in months and sex. All echocardiographic studies were carried out by the same investigator, according to the American Society of Echocardiography (ASE) convention, modification 2D using, Philips HD14000 Ultrasonograph. The LVM values were calculated at the end of diastole from: left ventricle dimension (LVDd), interventricular septum thickness (IVSd) and thickness of the posterior wall of the left ventricle (LVPWd). Data were analysed in relation to the body surface area (in 17 consecutive intervals from 0.2 m(2) to 1.8 m(2)) and to age (in months) for all children and for girls and boys separately. LVM values were calculated as a mean +/- SD and extreme values 5 or 95 percentile. The results were accepted as normal when they did not exceed 2SD or 5(th) or 9(th) percentile. Statistic analysis was performed with the use of rank correlation Spearman test and Mann-Whitney U.test.

RESULTS

The left heart ventricular mass was determined on the base of data from healty children aged 2 weeks to 18 years. A significant correlation of LVM with BSA and with age was found. There were no significant gender dependent differences in LVM values. Abnormal values exceeding the 95(th) percentile were present in 25 (3.2 %) examined children.

CONCLUSIONS

  1. LVM values obtained in this study can be used as reference values. 2. No gender differences were found in LVM. 3. BSA is a good reference parameter in calculating LVM in children aged 2 weeks-18 years. Both BSA and age give high correlation with left ventricular hypertrophy, in children with left muscular ventricular mass exceeding 95 percentile or + 2SD, long term care in department of cardiology is recommended.
摘要

背景

尽管对儿童左心室肥厚问题的关注度不断提高,但在发育年龄正常值数据中,关于左心室质量(LVM)正常值的已发表数据相对较少。

目的

确定婴儿和儿童LVM相对于体表面积(BSA)、年龄(月龄)和性别的正常值。

材料与方法

本研究对773名儿童(403名女孩和370名男孩,年龄从2周至18岁)进行。他们来自儿科和新生儿医院科室、门诊诊所及小学,被转诊进行超声心动图检查。所有患者均排除心血管疾病。根据BSA、月龄和性别计算LVM(克)。所有超声心动图检查均由同一名研究人员按照美国超声心动图学会(ASE)标准、使用飞利浦HD14000超声仪的改良二维方法进行。在舒张末期根据左心室内径(LVDd)、室间隔厚度(IVSd)和左心室后壁厚度(LVPWd)计算LVM值。对所有儿童以及分别对女孩和男孩的数据,根据体表面积(从0.2平方米至1.8平方米共17个连续区间)和年龄(月龄)进行分析。LVM值计算为平均值±标准差以及第5或第95百分位数的极值。当结果不超过2标准差或第5或第95百分位数时,被视为正常。采用Spearman秩相关检验和Mann-Whitney U检验进行统计分析。

结果

基于2周龄至18岁健康儿童的数据确定了左心室质量。发现LVM与BSA和年龄存在显著相关性。LVM值不存在显著的性别差异。在25名(3.2%)接受检查的儿童中出现了超过第95百分位数的异常值。

结论

  1. 本研究获得的LVM值可作为参考值。2. 在LVM方面未发现性别差异。3. BSA是计算2周龄至18岁儿童LVM的良好参考参数。对于左心室质量超过第95百分位数或+2标准差的儿童,BSA和年龄与左心室肥厚均具有高度相关性,建议在心脏病科进行长期护理。

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