7-14岁儿童青少年心脏形态结构功能发育特点及评价敏感指标筛选
Growth Characteristics and Sensitive Indices of Cardiac Morphology and Function for 7-14 Years Old Children and Adolescents

摘要：目的：观察7-14岁儿童青少年心脏形态结构及功能的生长发育变化规律，并筛选出评价心脏形态结构、功能发育的敏感指标。方法：选取四川广安市7-14岁儿童青少年作为研究对象，无心脏疾患，自愿参加本实验。符合要求的儿童青少年580例，其中男298例，女282例，按2岁一个年龄段将其分为4组：7-8岁组206例，9-10岁组123例，11-12岁组124例，13-14岁组127例。进行超声心动测试，检测心脏形态结构指标：室间隔舒张期厚度（IVSd）、室间隔收缩期厚度（IVSs）、左心室收缩期后壁厚度（LVPWs）、左心室舒张期后壁厚度（LVPWd）、左室舒张末期内径（LVDd）、左室收缩末期内径（LVDs）及主动脉内径（AOD）；左心室功能指标：左室舒张末期容积（EDV）、左室收缩末期容积（ESV）、心率（HR）、每搏量（SV）、射血分数（EF%）、左室短轴缩短率（FS%）、心输出量（CO）。结果：①7-10岁男童心脏形态结构指标与女童相比无明显差异，7-12岁男童心脏功能指标与女童相比无明显差异；②11-12岁男童心脏形态结构指标IVSd、IVSs、LVPWd、LVPWs 、AOD均明显大于9-10岁组（P＜0.01或P＜0.05），13-14岁男童心脏形态结构仍在继续发育；心脏功能指标从9-10岁开始，在11-14岁期间各指标有上升趋势，但无明显差异，以EF%、ESV和FS%变化为主。③女童心脏形态结构的发育从9-10岁开始，并且到了13-14岁出现另一个发育高峰期，提示女童心脏形态结构发育呈现双峰状态，敏感指标为IVSd、LVIDs、LVPWd、AOD。心脏功能指标发育趋势同形态结构指标，在9-10岁和13-14岁出现开始两个发育高峰，敏感指标为EF%、EDV、ESV和SV。结论：①心脏形态结构从11岁开始，功能从13岁开始出现性别差异。②男童的心脏功能发育从9-10岁开始，而形态结构发育从11-12岁开始，功能指标发育早于形态结构，而女童两者同步发育，且分别在9-10岁及13-14岁出现发育高峰期，呈现双峰状态。③评价儿童青少年心脏形态结构发育的敏感指标为IVSd、LVPWd、AOD；评价功能指标发育的敏感指标为EF%和ESV。
Abstract: Objectives: This study aimed at observing the growth law of cardiac morphology and function and screening the sensitive indices to evaluate the development of cardiac morphology and function for 7-14 years old children and adolescents. Methods: Five hundred and eighty healthy individuals (298 boys and 282 girls) aged 7-14 years old from Guang’an of Sichuan province were included in this study, and they were divided into 4 groups: 7-8 year old (206), 9-10 year old (123), 11-12 year old (124), and 13-14 year old (127). The indices of cardiac morphology and function were tested by ultrasonic echocardiography. The indices of cardiac morphology included IVSd, IVSs, LVPWs, LVPWd, LVDd, LVDs, AOD, the indices of cardiac function included EDV, ESV, HR, SV, EF%, FS%, and CO. Results: 1) There are no significant differences of cardiac morphology indices between 7-10 year old boys and girls and no significant differences of cardiac function indices between 7-12 year old boys and girls. 2) IVSd, IVSs, LVPWd, LVPWs, and AOD of 11-12 year old boys are significantly greater those of 9-10 year old boys (P < 0.05), and these indices of 13-14 year old boys are still changing; cardiac function indices especially EF%, ESV, and FS% are gradually growing during 9-14 year old, but no significant difference. 3) Girls’ cardiac morphology starts growing from 9-10 year old, and has another growth peak at 13-14 year old, which show double peak, and the sensitive morphology indices are IVSd, LVIDs, LVPWd and AOD; girls’ cardiac function has similar growth way as morphology indices, they also have double growth peak, and the sensitive function