Liqunliu

CHILDRENOBESITYDepartmentOfPediatrics第五章第六節(jié)（2）中南大學(xué)兒科學(xué)教研室PURPOSEANDREQUIREMENTTomasterthediagnosisandtreatmentofchildrenobesity.Tobefamiliarwiththeetiologyand

pathophysiologyofchildrenobesity.Tobefamiliarwiththeclinicalmanifestationofchildrenobesity.

肥胖癥（Obesity）是由于能量攝入長期超過人體的消耗，使體內(nèi)脂肪過度積聚、體重超過一定范圍的一種營養(yǎng)障礙性疾病。定義

ExcessiveintakeofnutrientsInadequateexerciseInheritfactorsTheothers

ETIOLOGYSIMPLEOBESITY影響小兒健康活動不便易感染，甚至出現(xiàn)心肺功能不全心理障礙成年期并發(fā)癥高血壓(Hypertension)

冠心病(Coronaryheartdisease)糖尿病(Diabetes)膽石癥(Cholelithiasis)痛風(fēng)(gout)危害性病理生理

營養(yǎng)素攝入>機(jī)體消耗多余的能量轉(zhuǎn)化為脂肪人體脂肪細(xì)胞數(shù)量人體脂肪細(xì)胞體積

肥胖病理生理肥胖脂肪代謝蛋白質(zhì)代謝內(nèi)分泌變化高脂血癥尿酸糖尿病肥胖骨質(zhì)病男性性功能低下女性月經(jīng)不調(diào)不孕動脈硬化冠心病高血壓膽石癥痛風(fēng)體征(signs)體脂豐滿，分布均勻皮膚紫紋(purplestriae)扁平足和膝外翻

(Theflatfootandgenu

valgum)男性陰莖(penis)隱藏在脂肪組織中CLINICALMANIFESTATIONSDIAGNOSIS

Bodymassindex(BMI):

Itistheoddsofweightandthesquareofheight.

standards

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ChildrenwithBMIsatthe95thpercentileormoreforageandsexorwhoseBMIsaremorethan30shouldbeconsideredoverweight.鑒別診斷肥胖兒（體脂分布均勻）Cushing’ssyndrome（滿月臉）治療原則減少熱能性食物攝入增加機(jī)體對熱能的消耗TREATMENT

ModificationofdietandcaloriccontentThedietcontainshigh-qualityproteins,lowfats,lowcarbohydratesThedietcontainsasmuchbulkaspossibleSufficientvitaminsandmineralssupplementation

DevelopthegoodhabitsofdietTREATMENTDefinitionanduseofappropriateexercisesprogramBehaviormodificationforthechild(includingpsychotherapy)GenetherapyDrugtreatment－ItisunsuitableforchildrenHungryorhalf-hungrytreatmentisforbidden

Fastweightloss(lessthan3months)isforbidden

Drug、foodordrinkon