目的 研究肥胖儿童血清巨噬细胞M1/M2型标志物水平与其发生心脏病变的风险预测价值。 方法 回顾性收集2024年6—12月在南昌大学第二附属医院就诊的60例肥胖儿童、50例健康儿童的资料。根据体重指数分为轻中度肥胖组（32例）、重度肥胖组（28例）和对照组（50例）。比较3组间一般资料及实验室指标、心脏彩超参数、巨噬细胞标志物［单核细胞趋化蛋白-1（monocyte chemoattractant protein-1, MCP-1）、精氨酸酶-1（arginase-1, Arg-1）、CD206、CD86］水平，分析巨噬细胞标志物水平与心脏彩超参数的相关性，以及肥胖儿童发生心脏病变的影响因素；利用受试者操作特征曲线分析评价各影响因素对肥胖儿童发生心脏病变的预测效能。 结果 3组心脏彩超参数比较，多个指标差异有统计学意义（P<0.01）；3组MCP-1、Arg-1水平、CD206阳性率、CD86/CD206比值差异均有统计学意义（P<0.05）。肥胖儿童MCP-1、Arg-1、CD86阳性率、CD206阳性率与心脏彩超参数有相关性（P<0.05）。单因素logistic回归分析显示，MCP-1、Arg-1、CD86/CD206比值、CD206阳性率是心脏病变的影响因素（P<0.05）；以上标志物联合预测心脏病变的受试者操作特征曲线下面积为0.887（P<0.01）。 结论 巨噬细胞标志物联合检测可预测肥胖儿童心脏早期病变的发生风险。

Objective To study the predictive value of serum macrophage M1/M2 markers for the risk of cardiac lesions in obese children. Methods A total of 60 obese children (mild-to-moderate obesity, n=32; severe obesity, n=28) and 50 healthy controls who visited the Second Affiliated Hospital of Nanchang University from June 2024 to December 2024 were included. The baseline characteristics and the levels of laboratory indicators, echocardiographic parameters, and macrophage markers (MCP-1, Arg-1, CD206, and CD86) were compared among the three groups. The correlation between macrophage marker levels and echocardiographic parameters and the influencing factors of cardiac lesions in obese children were analyzed. The receiver operating characteristic curve analysis was used to evaluate the predictive performance of each influencing factor for cardiac lesions in obese children. Results Multiple echocardiographic parameters differed significantly among the mild-to-moderate obesity, severe obesity, and control groups (P<0.01). Significant differences were also observed in MCP-1 and Arg-1 levels, CD206 positivity rate, and the CD86/CD206 ratio among the three groups (P<0.05). In obese children, MCP-1 and Arg-1 levels, as well as CD86 and CD206 positivity rates, were correlated with echocardiographic parameters (P<0.05). Univariate logistic regression identified MCP-1, Arg-1, the CD86/CD206 ratio, and the CD206 positivity rate as factors associated with cardiac lesions (P<0.05). The combined prediction model based on these markers yielded an area under the receiver operating characteristic curve of 0.887 (P<0.01). Conclusions Combined measurement of macrophage markers can predict the risk of early cardiac lesions in obese children.