摘要目的 探讨河北省某市中青年男性在职干部体质指数与心脏结构及功能的亚临床改变的关系.方法 根据体质指数(BMI)将160例研究对象分为正常体重组(BMI为18.5～23.9 kg/m2)、超重组(BMI为24.0 ～ 27.9 kg/m2)、轻度肥胖组(BMI为28.0 ～ 29.9 kg/m2)及重度肥胖组(BMI ≥30 kg/m2).应用超声心动图比较多组间心脏结构指标:收缩末期左室内径、舒张末期左室内径、室间隔及左室后壁厚度,左室重量和左室重量指数的差异；应用脉冲多普勒及组织多普勒成像技术比较组间心脏功能指标:左室每搏量指数,二尖瓣口血流频谱[舒张早期血流峰速(E)、舒张晚期血流峰速(A)]、二尖瓣环舒张及收缩期运动速度[舒张早期运动速度(Em)、舒张晚期运动速度(Am)、收缩期运动速度(Sm)]的差异.结果 与体重正常组比较,体重超标各组左室收缩及舒张末期内径增宽,室间隔及左室后壁增厚,左室重量及左室重量指数增加,二尖瓣的E峰,A峰升高,E/A比值降低,Em降低,Am升高,Em/Am比值降低,差异有统计学意义(P＜0.05),并随肥胖程度的加重有加重趋势；轻、重度肥胖的Sm与体重正常组差异有统计学意义(P＜0.05).结论 体重超标可引起该类人群心脏肥大,心脏舒张功能下降,并随BMI增加而加重；肥胖可致心脏收缩功能指标Sm减低.

abstractsObjective To investigate the relationship between body mass index(BMI)and cardiac structure and function of adult men living in Hebei province.Methods A total of 160 adults were assigned to 4 groups by BMI:normal body weight group(group A,BMI 18.5 to 23.9 kg/m2),overweight group (group B,BMI 24.0 to 27.9 kg/m2),mild obese group(group C,BMI 28.0 to 29.9 kg/m2),and severe obese group(group D,BMI ≥ 30 kg/m2).Left ventricular end-diastolic diameter(EDD),end-systolic diameter(ESD),inter ventricular septal thickness(IVS),left ventricular posterior wall thickness (LVPW),left ventricular mass(LVM),and left ventricular mass index(LVMI)were examined by echocardiography.Early(E)peak diastolic and late(A)diastolic mitral inflow velocity and E/A ratio were measured by Doppler echocardiography.Pulsed wave Doppler tissue image(PW-DTI)of the lateral mitral annulus was performed to evaluate early peak diastolic velocity(Em),late peak diastolic velocity(Am)and Em/Am ratio.Results Compared with group A,EDD,ESD,LNM,LVMI,Am,IVS and LVPW were increased in the other 3 groups(all P ＜ 0.05).E,E/A ratio,Em,and Em/Am ratio were decreased in group B,C,and D(all P ＜ 0.05).Compared with group B,Sm was decreased in group C and D(both P ＜ 0.05).Conclusion Overweight and obesity could contribute to ventricular hypertrophy and deteriorate diastolic function in a BMI dependent manner.Obesity may be also related to decreased Sm.