云南省3～6岁儿童血压水平及高血压评价标准的探讨

Investigation of blood pressure levels and standards for hypertension diagnosis in 3-to 6-year-old children in Yunnan Province

目的了解云南省3～6岁儿童血压水平及高血压患病情况。方法采用整群分层抽样方法对云南省14个地(州)、市的12个民族3～6岁儿童进行血压测量,并对其父母进行问卷调查。参照百分位数法、离差法和预定值法制定云南省3～6岁儿童高血压评价标准。结果共调查3～6岁儿童15877人,其中男童8042人,女童7835人。3～6岁儿童收缩压均值为(95.2±8.3)mmHg,舒张压均值为(62.6±7.7)mmHg。其血压随着年龄的增长而增加,男童收缩压高于女童,差异有统计学意义,舒张压无性别差异。若以收缩压≥110mmHg和收缩压≥第95百分位数值判定为高血压,其高血压患病率均为7.1%,以收缩压≥x珚+2s判定为高血压,则高血压患病率为2.4%;若以舒张压≥70mmHg或≥第95百分位数值或≥x珚+2s判定为高血压,其高血压患病率分别为24.3%、5.6%和4.7%。结论在目前常用的3种高血压评定标准中,以第95百分位数法较为合理;云南省3～6岁儿童高血压的诊断标准定为110/76mmHg是适宜的参考值。

Objective To investigate the blood pressure levels and hypertension prevalence in 3-to 6-year-old children in Yunnan Province.Methods With cluster stratified sampling,we measured the blood pressure of 3-to 6-year-old children from 14 counties of 12 different nationalities,and conducted a questionnaire survey in their parents.The hypertension evaluation criteria were set by percentile,deviation and predetermined value.Results Totally 15 877 children of 3 to 6 years old（8042 boys and 7835 girls） were involved in this study.The mean systolic blood pressure（SBP） and diastolic blood pressure（DBP） of those children were（95.2±8.3） and（62.6±7.7）mm Hg,respectively.It was found that blood pressure increased with age.The SBP levels in boys were significantly higher than those in girls,while DBP levels showed no significant difference between the two groups.When SBP≥110 mm Hg and 95 percentile were set as the indicators for hypertension,the prevalence would be 7.1% in relation to the collected data.When SBP≥＋2s was supposed as the index to disgnose hypertension,the prevalence would be 2.4%.However,when DBP≥70 mm Hg,95 percentile or ＋2s were used as the indexes,the prevalence would be 24.3%,5.6% and 4.7%,respectively.Conclusion Among the three hypertension evaluation criteria,95 percentile is the most reasonable.The normal blood pressure of the children of 3-6 years old in Yunnan Province should be reset as 110/76 mm Hg.