小儿血压动态变化及临床影响因素的研究

The Study of the Dynamic Change and Clinical Influence Factors of Children's Blood Pressure

目的观察婴儿、幼儿、学龄前期儿童血压分布百分位、血压的动态变化及临床影响因素。方法选择健康儿童共800名,根据年龄分为3组:婴儿组100名,幼儿组192名,学龄前组508名。分别检测各年龄组儿童血压,同时测量身高、体重、臂围,计算体重指数。并对幼儿、学龄前组进行小儿血压发育规律相关因素的调查。结果①3组小儿血压均呈正态分布;临界高血压发生率为8.25%,主要发生在幼儿、学龄前组;②婴儿组四肢血压与体位、性别差异均无显著性(P>0.05);③幼儿组坐、卧两种体位下测量的血压,表现为坐位测量的下肢舒张压高于卧位测量值;④3组小儿血压值婴儿<幼儿<学龄前儿,差异有显著性(P<0.05),2岁后小儿的动脉收缩压符合年龄×2+80mmHg、舒张压=2/3收缩压的规律;⑤小儿动脉收缩压与体重、体重指数呈正相关性(P<0.01),与出生胎次、性别、孕母职业、文化程度、生活习惯及预防注射未表现出相关性(P>0.05)。结论小儿血压受年龄及体重的影响,表现随年龄增长递增现象;血压计袖带的选用影响血压的测定值;高血压家族史、肥胖是小儿高血压的风险因素。

Objective To observe the normal percentile distribution of blood pressure in infants,young children and preschool children. To test the dynamic change and clinical influence factors of children g blood pressure. Methods A total of 800 healthy children were chosen to divided into 3 groups according to their age,which infants group including 100 children,the young children including 192 children, and preschool children including 508 children. The professionsis of the topic-group measured their BP with home sphygmo.manometer, and their height,weight, arm circumference and the weight. Results ①The percentiles of SBP and DBP in young children, preschool children was in normal distribution;The incidence rate of borderline hypertension was 8.25%. Mainly in young children group and preschool children group ;②The mean of SBP and DBP was no significant difference between boys and girls（ P 〉 0.05） ;The mean BP of the four limbs in infants group and young chihtren group was no significant difference（ P 〉 0.05 ）;③In young children group,the BP that was measured at seat position was higher than that was measured at decubitus position; ④As years gone, the mean of BP increased with 5 ～10mmHg in the three groups,and there was significant difference （ P 〈 0.05 ）. After 2 years old, their SBP （ mmHg ） = age ×2 ＋ 80, DBP （mmHg） = 2/3SBP; ⑤ Clinical influence factors of children＇s BP：there was significant correlation between children＇s SBP and weight（ P 〈0.01 ） ;The children＇s BP was relative to the pregnant times, the sex, the occupation of pregnant women, the cultural level and the injection of vaccine ;The incidence of hypertension of children was relative to the family history of hypertension and fatness （ P 〈 0.05 ）. Conclusion The sleeve of sphygmomanometer has influence to the children＇s BP,especially when measured the lower limbs;Age and weight also has influence to the children＇s BP, it expressed as “locus phenomena” ,that BP increased with the age ;The incidence of borderline hypertension of children is related with the family history of hypertension and fatness.