中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2012年
11期
839-842
,共4页
赵娟%杨锦艳%金红芳%杜军保
趙娟%楊錦豔%金紅芳%杜軍保
조연%양금염%금홍방%두군보
儿童%疾病特征%直立性高血压
兒童%疾病特徵%直立性高血壓
인동%질병특정%직립성고혈압
Child%Disease attributes%Orthostatic hypertension
目的 探讨儿童直立性高血压(OHT)的临床特征.方法 收集在北京大学第一医院儿科门诊诊断为OHT的患儿96例,分析其人口学特征、病程及体位变化引起的血流动力学改变,同时观察各种临床表现的发生频率及其诱发因素.结果 在96例OHT患儿中,男50例,女46例,年龄(11.8±2.7)岁.病程小于1个月者22例,占22.9％;病程在1个月到1年之间者49例,占51.1％.就诊时最常见的临床表现为晕厥、头晕、恶心呕吐等,多在患儿突然体位变化(由卧位变为站立位)(占24.0％)或持久站立(占57.3％)的情况下发生;其他诱发因素包括运动、情绪变化、环境闷热等.患儿平卧位收缩压和舒张压分别为(103±8)mm Hg(1mm Hg=0.133 kPa)和(59 ±6)mm Hg,直立3 min时收缩压和舒张压分别为(113 ±8)mm Hg和(73 ±6)mm Hg,差异有统计学意义(t=27.674、17.936,P均＜0 01);平卧位心率(81±11)次/min,站立3 min内心率最大值(113±12)次/min(t=33.092,P＜0.01).结论 OHT患儿多处于青春发育期,晕厥和头晕为主要临床症状,多由体位改变或持久站立诱发.患儿由平卧位转为直立体位时,血压明显升高.
目的 探討兒童直立性高血壓(OHT)的臨床特徵.方法 收集在北京大學第一醫院兒科門診診斷為OHT的患兒96例,分析其人口學特徵、病程及體位變化引起的血流動力學改變,同時觀察各種臨床錶現的髮生頻率及其誘髮因素.結果 在96例OHT患兒中,男50例,女46例,年齡(11.8±2.7)歲.病程小于1箇月者22例,佔22.9％;病程在1箇月到1年之間者49例,佔51.1％.就診時最常見的臨床錶現為暈厥、頭暈、噁心嘔吐等,多在患兒突然體位變化(由臥位變為站立位)(佔24.0％)或持久站立(佔57.3％)的情況下髮生;其他誘髮因素包括運動、情緒變化、環境悶熱等.患兒平臥位收縮壓和舒張壓分彆為(103±8)mm Hg(1mm Hg=0.133 kPa)和(59 ±6)mm Hg,直立3 min時收縮壓和舒張壓分彆為(113 ±8)mm Hg和(73 ±6)mm Hg,差異有統計學意義(t=27.674、17.936,P均＜0 01);平臥位心率(81±11)次/min,站立3 min內心率最大值(113±12)次/min(t=33.092,P＜0.01).結論 OHT患兒多處于青春髮育期,暈厥和頭暈為主要臨床癥狀,多由體位改變或持久站立誘髮.患兒由平臥位轉為直立體位時,血壓明顯升高.
목적 탐토인동직립성고혈압(OHT)적림상특정.방법 수집재북경대학제일의원인과문진진단위OHT적환인96례,분석기인구학특정、병정급체위변화인기적혈류동역학개변,동시관찰각충림상표현적발생빈솔급기유발인소.결과 재96례OHT환인중,남50례,녀46례,년령(11.8±2.7)세.병정소우1개월자22례,점22.9％;병정재1개월도1년지간자49례,점51.1％.취진시최상견적림상표현위훈궐、두훈、악심구토등,다재환인돌연체위변화(유와위변위참립위)(점24.0％)혹지구참립(점57.3％)적정황하발생;기타유발인소포괄운동、정서변화、배경민열등.환인평와위수축압화서장압분별위(103±8)mm Hg(1mm Hg=0.133 kPa)화(59 ±6)mm Hg,직립3 min시수축압화서장압분별위(113 ±8)mm Hg화(73 ±6)mm Hg,차이유통계학의의(t=27.674、17.936,P균＜0 01);평와위심솔(81±11)차/min,참립3 min내심솔최대치(113±12)차/min(t=33.092,P＜0.01).결론 OHT환인다처우청춘발육기,훈궐화두훈위주요림상증상,다유체위개변혹지구참립유발.환인유평와위전위직입체위시,혈압명현승고.
Objective To study the clinical characteristics of orthostatic hypertension (OHT) in children.Method A total of 96 children with OHT who met the diagnostic criteria and clinical manifestations were recruited in the Department of Pediatrics,Peking University First Hospital.Age and sex distributions were observed.The duration of disease,the frequencies of symptoms and the predisposing factors were recorded.The hemodynamic changes from supine to up-right positions were also analyzed.Result There were 50 boys and 46 girls in the study group.The mean age was (11.8 ± 2.7) years.Thirtytwo children were from 6 to 10 years old,accounting for 33.3％ of all subjects,while 64 patients were from 11 to 17 years old,accounting for 66.7％.Durations of symptoms of OHT were less than 1 month in 22.9％ children,from 1 month to 1 year in 51.1％ children and longer than 1 year in 26.0％ children.The most common clinical manifestations were syncope and dizziness.The incidence of them was 70.8％ and 46.9％,respectively.Other clinical manifestations included transitional amaurosis,nausea and/or vomiting,pallor and so on.These clinical manifestations often occurred on position change (24.0％) and long-time standing (57.3％) in children.Other predisposing factors included exercise,emotion changes and fuggy environment.The baseline systolic and diastolic blood pressures were (103 ± 8) mm Hg (1 mm Hg =0.133kPa) and (59 ±6) mm Hg,respectively,the up-right systolic and diastolic blood pressure at 3 min were (113 ±8) mm Hg and (73 ±6) mm Hg and the differences were significant (t =27.674,P ＜0.01; t =17.936,P ＜0.01).The baseline heart rate in supine position was (81 ± 11) bpm and the maximum heart rate in up-right position was (113 ± 12) bpm (t =33.092,P ＜ 0.01).Conclusion OHT is commonly seen in puberty of children.The chief complaints are syncope and dizziness.They were mostly induced by position change and long-time standing.Blood pressure was significantly increased from supine to up-right position.
