儿童及青少年血压踏车运动负荷试验的临床意义

The Clinical Value of Bicycle Exercise Stress Test in Children and Adolescents with High Risk Factors of Hypertension

对我们在１９８７年进行的踏车血压运动负荷试验的２３６名６～１９岁健康儿童及青少年分别于１９９２年、１９９４年随访血压及踏车运动试验，并采用１９８７年拟定的运动试验阳性标准，对安静收缩血压９０以上百分位（Ｐ）与运动试验阳性者进行横向及纵向分析。得出以下结论：１．１９８７年血压４５～５５Ｐ及≥９０Ｐ组，运动试验阳性率分别为１１．８％及４３．５％；２．三个年度血压均≥９０Ｐ组，两次≥９０Ｐ组及一次≥９０Ｐ组，三次运动试验均阳性的百分比分别为５４．２％，８．２％及２．４％；３．１９８７年血压≥９０Ｐ者按运动试验阳性、阴性分组分析１９９２、１９９４年血压资料，阳性组血压仍保持≥９０Ｐ者为６５．５％、４７．３％，阴性者为２９．２％及２０．３％；４．１９８７年血压≥９０Ｐ者运动试验阳性组中１９９２、１９９４年两年血压均≥９０Ｐ者明显高于阴性组，分别为３４．５％及７．２％；（以上均经统计学处理Ｐ＜０．００１或Ｐ＜０．００５）说明本课题拟定的血压运动负荷试验标准有明确的临床价值。

A group of 236 healthy children and adolescents(aged 6-19),who underwent exercise stress bicycle ergometry and blood pressure(BP) measurement in l987 have been followed up again in l992 and l994.The criterion of positive test adopted in l987 was used in l992 and l994.Results:1.The positive rates of stress test were 11.8% in the 45-55P group of BP and 43.5% in the≥90P group of BP respectively.(P<0.005).2.The percentage of three times of positive stress tests are 54.2%,in the 3 times BP≥90P group during l987,1992 and l994,8.2% in the2 times BP≥90P group and 2.4% in the one time respectively.(P<0.001).3. The percentage of BP≥90P in l992, 1994 are 65.5 % and 47.3% in the group of BP≥90P with positive stress test in l987 respectively, and the percentage of BP≥90P in l992,1994 are 29.0% and 20.3% in the group of BP≥90P with negative stress test in l987 respectively.(P<0.001).4.The percentage of two times of BP≥90P in l992,1994 are 34.5% in the group of BP≥90P with positive stress test in 1987, and 7.2% in the group of BP≥90P with negative stress test in l987 respectively.(P<0.001).Conclusion The criteria for blood pressure bicycle exercise stress test adopted in l987 has definite clinical value for children and adolescents with high risk factors of hypertension.