超重、肥胖中专女生心血管功能及心理健康状况评定
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摘要
目的 分析超重、肥胖中专女生的最大氧耗量和负荷运动后血压、脉搏等变化，评价超重、肥胖对女性青少年心血管功能的影响；分析超重、肥胖对中专女生抑郁、焦虑等情绪症状和自我意识的影响，为学校指导肥胖女性青少年控制体重，保护心肺功能，开展心理健康教育提供依据。
方法 在某中专学校对1302名15～20岁女生进行身高、体重测量，用身高标准体重法判定35例肥胖、62例超重女生，同时选取100名正常体重女生为对照。测清晨静卧时脉搏与血压；用30秒20次蹲起试验进行定量负荷运动试验，测量负荷运动前后的脉搏与血压；并用台阶运动试验测5min即刻脉搏，得出最大氧耗量、最大氧耗量相对值。采用方差分析法比较三组中专女生最大氧耗量绝对值和相对值以及负荷运动前后脉搏、血压变化差异的统计学显著意义。用流调用抑郁自评量表、Zung焦虑评定量表和Piers-Harris儿童自我意识评定量表，分别评定三组研究对象的抑郁、焦虑等情绪症状和自我意识。
结果 超重、肥胖中专女生的最大氧耗量相对值显著低于对照组，清晨静卧位及负荷运动前后的脉搏、血压水平亦高于对照组。运动后的脉搏上升百分比均大于对照组，差异有显著性意义(P＜0.05)。肥胖组抑郁、焦虑症状检出率分别为37.1％、22.9％，超重组为14.5％、6.5％，对照组为22.0％、7.0％，三组检出率比较差异均有显著性意义(P＜0.05)；肥胖组自我意识总分和3个分量表分显著地低于超重组和对照组，三组差异有显著性意义。超重组自我意识评分与对照组间的差异无统计学显著意义。
结论 超重、肥胖对女性青少年心血管功能有显著影响。中专肥胖女生的抑郁、焦虑状况较为严重，肥胖可能降低中专女生的自我意识。
Objective To analyze changes of the maximum oxygen uptake, pulse and blood pressure after loading locomotion in overweight and obese girls of technical secondary school, and evaluate the influence of overweight and obesity on cardiovascular functions in female adolescents, and to analyze the effect of overweight and obesity on self- concept and some emotional symptoms such as depression and anxiety among these girls, in order to provide some evidence for the school-based directions of weight control, cardiopulmonary function protection and to provide the basis for the mental health education of overweigh and obese female adolescents in schools.
Method Height and weight was measured in 1302 female students aged 15-20y. 35 and 62 students are classified as obesity and overweight respectively according to weight-for-height method, 100 normal weight students are enrolled as control. Pulse and blood pressure were measured in decubitus early morning, before and after the loading locomotion by squating down and rising up 20 times in 30 seconds. We measured the pulse in instant 5 minutes by step test, found the estimation of the maximum oxygen uptake on Astrand linear chart according to the examinee's pulse and weight and calculated the relative value of the maximum oxygen uptake. In the same time, we compared their absolute and relative values of the maximum oxygen uptake and changes of pulse and blood pressure surrounding the test by ANOVA to see whether there was some difference or not. We utilized Center for Epidemiologic Studies Depression Scale, Zung self-rating Anxiety Scale and Piers-Harris Children' s self-concept scale to rate emotional symptoms
and self-concept of students in the three groups.
Result Maximum oxygen uptake for weight in obese female students was significant higher than that of overweight students and the control. Pulse and blood pressure in decubitus early morning or before and after the loading locomotion in obese females were higher than that of overweight and normal -weight female students. The percentage of pulse increase in obese and over-weight girls were higher than the control. The rates of
depression and anxiety symptoms were 37.1% and 22.9% in obese group, 14.5% and 6.5% in overweigh group, 22.0% and 7.0% in control group respectively. The prevalence of depression symptoms in obese group was higher than that in overweigh group significantly (p<0.05). The prevalence of anxiety symptoms in obese group was higher than that in other groups significantly (p<0.05). The total score on self-concept and scores in three sub-scales including anxiety, gregariousness, well-being and satisfaction were different among the three groups significantly, which in obese group were significantly lower than those in other groups. But there was no significant difference in the total score on self-concept between overweigh group and the control group.
Conclusion Overweight and obesity have significant influence on cardiovascular functions to female adolescents. The depression and anxiety symptom of obese girls in technical secondary school is serious. Obesity may decrease their self-concept.
方法 在某中专学校对1302名15～20岁女生进行身高、体重测量，用身高标准体重法判定35例肥胖、62例超重女生，同时选取100名正常体重女生为对照。测清晨静卧时脉搏与血压；用30秒20次蹲起试验进行定量负荷运动试验，测量负荷运动前后的脉搏与血压；并用台阶运动试验测5min即刻脉搏，得出最大氧耗量、最大氧耗量相对值。采用方差分析法比较三组中专女生最大氧耗量绝对值和相对值以及负荷运动前后脉搏、血压变化差异的统计学显著意义。用流调用抑郁自评量表、Zung焦虑评定量表和Piers-Harris儿童自我意识评定量表，分别评定三组研究对象的抑郁、焦虑等情绪症状和自我意识。
结果 超重、肥胖中专女生的最大氧耗量相对值显著低于对照组，清晨静卧位及负荷运动前后的脉搏、血压水平亦高于对照组。运动后的脉搏上升百分比均大于对照组，差异有显著性意义(P＜0.05)。肥胖组抑郁、焦虑症状检出率分别为37.1％、22.9％，超重组为14.5％、6.5％，对照组为22.0％、7.0％，三组检出率比较差异均有显著性意义(P＜0.05)；肥胖组自我意识总分和3个分量表分显著地低于超重组和对照组，三组差异有显著性意义。超重组自我意识评分与对照组间的差异无统计学显著意义。
结论 超重、肥胖对女性青少年心血管功能有显著影响。中专肥胖女生的抑郁、焦虑状况较为严重，肥胖可能降低中专女生的自我意识。
Objective To analyze changes of the maximum oxygen uptake, pulse and blood pressure after loading locomotion in overweight and obese girls of technical secondary school, and evaluate the influence of overweight and obesity on cardiovascular functions in female adolescents, and to analyze the effect of overweight and obesity on self- concept and some emotional symptoms such as depression and anxiety among these girls, in order to provide some evidence for the school-based directions of weight control, cardiopulmonary function protection and to provide the basis for the mental health education of overweigh and obese female adolescents in schools.
Method Height and weight was measured in 1302 female students aged 15-20y. 35 and 62 students are classified as obesity and overweight respectively according to weight-for-height method, 100 normal weight students are enrolled as control. Pulse and blood pressure were measured in decubitus early morning, before and after the loading locomotion by squating down and rising up 20 times in 30 seconds. We measured the pulse in instant 5 minutes by step test, found the estimation of the maximum oxygen uptake on Astrand linear chart according to the examinee's pulse and weight and calculated the relative value of the maximum oxygen uptake. In the same time, we compared their absolute and relative values of the maximum oxygen uptake and changes of pulse and blood pressure surrounding the test by ANOVA to see whether there was some difference or not. We utilized Center for Epidemiologic Studies Depression Scale, Zung self-rating Anxiety Scale and Piers-Harris Children' s self-concept scale to rate emotional symptoms
and self-concept of students in the three groups.
Result Maximum oxygen uptake for weight in obese female students was significant higher than that of overweight students and the control. Pulse and blood pressure in decubitus early morning or before and after the loading locomotion in obese females were higher than that of overweight and normal -weight female students. The percentage of pulse increase in obese and over-weight girls were higher than the control. The rates of
depression and anxiety symptoms were 37.1% and 22.9% in obese group, 14.5% and 6.5% in overweigh group, 22.0% and 7.0% in control group respectively. The prevalence of depression symptoms in obese group was higher than that in overweigh group significantly (p<0.05). The prevalence of anxiety symptoms in obese group was higher than that in other groups significantly (p<0.05). The total score on self-concept and scores in three sub-scales including anxiety, gregariousness, well-being and satisfaction were different among the three groups significantly, which in obese group were significantly lower than those in other groups. But there was no significant difference in the total score on self-concept between overweigh group and the control group.
Conclusion Overweight and obesity have significant influence on cardiovascular functions to female adolescents. The depression and anxiety symptom of obese girls in technical secondary school is serious. Obesity may decrease their self-concept.
引文
1. Prentice AM. Obesity and its potential mechanistic basis. British Medical Bulletin,2001; 60:51-67
2．何华，徐臻荣，何德润．石河子市儿童肥胖现状及对心理行为影响．疾病控制杂志，2001；5(1)：45-47
3. Steinberger J, Moran A, Hong CP, et al. Adiposity in childhood predicts obesity and insulin resistance in young adulthood. J Pediatr, 2001; 138: 453～454.
4. Sorof J, Domiels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension, 2002; 40:441～447.
5．季成叶，孙军玲，陈天娇．中国学龄儿童青少年1985～2000年超重、肥胖流行趋势．中华流行病学杂志，2004；25(2)：103～108
6．管晓丽，张亨菊，毕振旺．单纯性肥胖对儿童青春期发育的影响．中国校医，2003；17(1)：56
7．何静娟，陈彦平，王祥，等．小儿单纯肥胖内分泌变化的研究．中国优生与遗传杂志，1994；2(1)：106～107
8．夏庆华．肥胖对儿童身心健康的影响．中国学校卫生，2001；22(5)：473～474
9．季成叶，林琬生，张玉青，等．超重肥胖对青少年心肺功能的影响．中国运动医学杂志，1994；13(3)：157～161
10．李靖，时悦，Feners RJ，等．重度肥胖对肺功能及运动试验中呼吸模式的影响．新医学，2000；31(9)：527～529
11．胡云峰，章书胜，倪可月．儿童肥胖症与血压的关系．中国学校卫生，2002；23(5)：439～440
12．陈其，诸茂平，张圆海，等．单纯性肥胖儿童心血管功能评估．中华临床医药，2001；2(3)：11～12
13. Sorof JM, Poffenbarger T, Franco K, et al. Isolated systolic hypertension, obesity, and hypertentic hemodynamic states in children. J Pediatr, 2002; 140: 660～666.
14. Osei K. Insulin resistance and systemic hypertension. Am J Cardiol, 1999; 84 (1A):33～36
15. Kar AK, Mandal M. Hypertension, insulin resistence and atherosclerosis . J Indian MedAssoc, 1999; 97(3): 86～90
16. Lughetti L, Bedogni G, Ferrari M, et al. Is fasting insulin associated with blood
pressure in obese children? Ann Hum Biol, 2002; 27: 499～506.
17. Nishina M, Kikuchi T, Yamazaki H, et al. Relationship among systolic blood pressure, serum insulin and leptin, and visceral fat accumulation in obese children. Hypertens Res, 2003; 26(4): 281～288.
18. Tounion P, Aggoun Y, Dubern B, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet, 2001 ;358:615～620.
19. Li AM, Chan D, Wong E, et al. The effects of obesity on pulmonary function. Arch Dis Child, 2003; 88(4): 361～1363
2．何华，徐臻荣，何德润．石河子市儿童肥胖现状及对心理行为影响．疾病控制杂志，2001；5(1)：45-47
3. Steinberger J, Moran A, Hong CP, et al. Adiposity in childhood predicts obesity and insulin resistance in young adulthood. J Pediatr, 2001; 138: 453～454.
4. Sorof J, Domiels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension, 2002; 40:441～447.
5．季成叶，孙军玲，陈天娇．中国学龄儿童青少年1985～2000年超重、肥胖流行趋势．中华流行病学杂志，2004；25(2)：103～108
6．管晓丽，张亨菊，毕振旺．单纯性肥胖对儿童青春期发育的影响．中国校医，2003；17(1)：56
7．何静娟，陈彦平，王祥，等．小儿单纯肥胖内分泌变化的研究．中国优生与遗传杂志，1994；2(1)：106～107
8．夏庆华．肥胖对儿童身心健康的影响．中国学校卫生，2001；22(5)：473～474
9．季成叶，林琬生，张玉青，等．超重肥胖对青少年心肺功能的影响．中国运动医学杂志，1994；13(3)：157～161
10．李靖，时悦，Feners RJ，等．重度肥胖对肺功能及运动试验中呼吸模式的影响．新医学，2000；31(9)：527～529
11．胡云峰，章书胜，倪可月．儿童肥胖症与血压的关系．中国学校卫生，2002；23(5)：439～440
12．陈其，诸茂平，张圆海，等．单纯性肥胖儿童心血管功能评估．中华临床医药，2001；2(3)：11～12
13. Sorof JM, Poffenbarger T, Franco K, et al. Isolated systolic hypertension, obesity, and hypertentic hemodynamic states in children. J Pediatr, 2002; 140: 660～666.
14. Osei K. Insulin resistance and systemic hypertension. Am J Cardiol, 1999; 84 (1A):33～36
15. Kar AK, Mandal M. Hypertension, insulin resistence and atherosclerosis . J Indian MedAssoc, 1999; 97(3): 86～90
16. Lughetti L, Bedogni G, Ferrari M, et al. Is fasting insulin associated with blood
pressure in obese children? Ann Hum Biol, 2002; 27: 499～506.
17. Nishina M, Kikuchi T, Yamazaki H, et al. Relationship among systolic blood pressure, serum insulin and leptin, and visceral fat accumulation in obese children. Hypertens Res, 2003; 26(4): 281～288.
18. Tounion P, Aggoun Y, Dubern B, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet, 2001 ;358:615～620.
19. Li AM, Chan D, Wong E, et al. The effects of obesity on pulmonary function. Arch Dis Child, 2003; 88(4): 361～1363