儿童肥胖儿科目要求children obesity22.pptx

LiqunliuCHILDRENOBESITYDepartmentOfPediatrics第五章第六节（2）中南大学儿科学教研室

PURPOSEANDREQUIREMENTTomasterthediagnosisandtreatmentofchildrenobesity.Tobefamiliarwiththeetiologyandpathophysiologyofchildrenobesity.Tobefamiliarwiththeclinicalmanifestationofchildrenobesity.

肥胖症（Obesity）是由于能量摄入长期超过人体的消耗，使体内脂肪过度积聚、体重超过一定范围的一种营养障碍性疾病。定义

分类单纯性肥胖症(Simpleobesity)继发性肥胖症(Secondaryobesity)

ExcessiveintakeofnutrientsInadequateexerciseInheritfactorsTheothersETIOLOGYSIMPLEOBESITY

影响小儿健康活动不便易感染，甚至出现心肺功能不全心理障碍成年期并发症高血压(Hypertension)冠心病(Coronaryheartdisease)糖尿病(Diabetes)胆石症(Cholelithiasis)痛风(gout)危害性

病理生理营养素摄入机体消耗多余的能量转化为脂肪人体脂肪细胞数量人体脂肪细胞体积肥胖

病理生理肥胖脂肪代谢蛋白质代谢内分泌变化高脂血症尿酸糖尿病肥胖骨质病男性性功能低下女性月经不调不孕动脉硬化冠心病高血压胆石症痛风

CLINICALMANIFESTATIONSAges:itoftenoccursinthe1styroflife,at5～6yrofage,andduringadolescence.SymptomsGoodappetite,befondofsweetmeatsanddietfryFatigue,panting,andthePickwickiansyndromePsychologicobstacle

体征(signs)体脂丰满，分布均匀皮肤紫纹(purplestriae)扁平足和膝外翻(Theflatfootandgenuvalgum)男性阴茎(penis)隐藏在脂肪组织中CLINICALMANIFESTATIONS

DIAGNOSISTheoddsofweightandheightstandards---Childrenwithweightis20%morethanthemeanvalueofthesamesexandheight.Mild:20%-29%Mid:30%-39%Severe:40%-59%Veryserious:60%

DIAGNOSISBodymassindex(BMI):Itistheoddsofweightandthesquareofheight.standards—ChildrenwithBMIsatthe95thpercentileormoreforageandsexorwhoseBMIsaremorethan30shouldbeconsideredoverweight.

鉴别诊断伴肥胖的遗传性疾病Prader-WillisyndromeLaurence-Moon-BiedlsyndromeAlstromsyndrome伴肥胖的内分泌疾病甲状腺功能减退症(hypothyroidism)肾上腺皮质增生症(Hyperadrenocorticism)

鉴别诊断肥胖儿（体脂分布均匀）Cushing’ssyndrome（满月脸）

治疗原则减少热能性食物摄入增加机体对热能的消耗

TREATMENTModificationofdietandcaloriccontentThedietcontainshigh-qualityproteins,lowfats,lowcarbohydratesThedietcont