CAJ | 학술논문

目的比较原发性高血压及血压正常儿童的心血管结构和功能情况,分析原发性高血压儿童心血管结构及功能的早期改变及其影响因素.方法对经过非同日3个时点电子血压计筛查的213名6～18岁原发性高血压儿童(病例组)检测心脏结构和血管功能,并采用性别、年龄成组匹配,以197名血压正常儿童为对照组进行病例对照分析.结果 (1)病例组左心室舒张末期内径(LVEDd)、收缩末期内径(LVESd)、左心室质量(LVM)、左心室质量指数(LVMI)均高于对照组(均P＜0.05),但两组间颈动脉内膜中层厚度(cIMT)、相对室壁厚度(RWT)、踝—臂脉搏波传导速度(baPWV)的差异无统计学意义(均P＞0.05).(2)不同年龄及肥胖程度儿童中,病例组LVEDd、LVESd、LVM、LVMI均高于对照组(均P＜0.05),但两组间cIMT、RWT的差异无统计学意义(均P＞0.05);而baPWV在低年龄儿童中,病例组检测值低于对照组(P＜0.05).(3)多元线性回归发现,高血压是LVMI的主要影响因素,而RWT的主要影响因素是年龄和BMI.结论无临床症状的低龄高血压儿童已发生左心室重构,但尚未发现血管结构和功能的改变.
목적 비교원발성고혈압급혈압정상인동적심혈관결구화공능정황,분석원발성고혈압인동심혈관결구급공능적조기개변급기영향인소.방법 대경과비동일3개시점전자혈압계사사적213명6～18세원발성고혈압인동(병례조)검측심장결구화혈관공능,병채용성별、년령성조필배,이197명혈압정상인동위대조조진행병례대조분석.결과 (1)병례조좌심실서장말기내경(LVEDd)、수축말기내경(LVESd)、좌심실질량(LVM)、좌심실질량지수(LVMI)균고우대조조(균P＜0.05),단량조간경동맥내막중층후도(cIMT)、상대실벽후도(RWT)、과—비맥박파전도속도(baPWV)적차이무통계학의의(균P＞0.05).(2)불동년령급비반정도인동중,병례조LVEDd、LVESd、LVM、LVMI균고우대조조(균P＜0.05),단량조간cIMT、RWT적차이무통계학의의(균P＞0.05);이baPWV재저년령인동중,병례조검측치저우대조조(P＜0.05).(3)다원선성회귀발현,고혈압시LVMI적주요영향인소,이RWT적주요영향인소시년령화BMI.결론 무림상증상적저령고혈압인동이발생좌심실중구,단상미발현혈관결구화공능적개변.
Objective To assess the cardiovascular structure and function in children with confirmed primary hypertension,and to explore the impact of hypertension and related risk factors on cardiovascular structure and function of children.Methods Parameters related to cardiac structure,vascular structure and function were measured in 213 hypertensive children,who were confirmed upon repeated measurements on separate occasions.A total of 197 healthy children were recruited as controls.Results 1) In hypertensive children,left ventricular end-diastolic diameter (LVEDd),left ventricular end-systolic diameter (LVESd),left ventricular mass (LVM),left ventricular mass index (LVMI),left ventricular posterior wall thickness (LVPT) and interventricular septal thickness (IVST) were all significantly higher than their counterparts (P＜0.05).No statistical differences were found in carotid intima-media thickness (cIMT),relative wall thickness (RWT) and brachial ankle pulse wave velocity (ba-PWV).2) Compared with controls,LVEDd,LVESd,LVM,LVMI were all significantly higher in hypertensive children (P＜0.05),regardless of age group or weight-status.No statistical differences were found in ccIMT and RWT,while ba-PWV was statistically higher in controls among children aged 6-12 years.3) Data from multiple linear regression analysis noticed that LVMI was associated with age,sex,BMI and hypertension while RWT was associated with age and BMI.Conclusion In children with primary hypertension,changes of vascular structure and function were not shown but left ventricular remodeling and early changes of function had been developed in children under 12 years old.