儿童继发性高血压120例临床分析

Clinical analysis of secondary hypertension in 120 children

目的 分析儿童继发性高血压的临床特征,探讨引起本病的病因,提高临床诊断及治疗.方法 回顾性分析120例继发性高血压患儿的临床资料.结果 1.本组120例患儿中男79例（65.8％,79/120例）,女41例（34.2％,41/120例）;年龄0.5～16.7（9.5±4.1）岁.2.主要临床表现：水肿55例（45.8％,55/120例）,惊厥52例（43.3％,52/120例）,头痛49例（40.8％,49/120例）,呕吐44例（36.7％,44/120例）,头晕33例（27.5％,33/120例）,少尿24例（20.0％,24/120例）.3.肾性高血压77例（64.2％,77/120例）,药物性高血压22例（18.3％,22/120例）,内分泌疾病5例（4.2％,5/120例）,风湿性疾病4例（3.3％,4/120例）,心源性高血压3例（2.5％,3/120例）,神经母细胞瘤2例（1.7％,2/120例）.4.高血压脑病71例（59.2％,71/120例）.其中原发病为急性肾小球肾炎47例（66.2％,47/71例）.5.有111例患儿随原发病的好转血压均降至正常,9例患儿家长放弃治疗出院.结论 儿童继发性高血压多由急性肾小球肾炎引起,易并发高血压脑病;早期诊断并积极治疗原发病可改善继发性高血压的预后.

Objective To analyze clinical features of secondary hypertension in children,and explore the etiology of secondary hypertension and improve the clinical diagnosis and treatment.Method Retrospective analysis of the clinical features in 120 children with secondary hypertension was performed.Results 1.Seventy-nine patients （65.8％,79/120 cases） were male,41 patients（34.2％,41/120 cases） were female.The mean age was （9.5-±4.1）years old.2.Main clinical manifestations：55 cases of edema （45.8％,55/120 cases）,52 cases of seizure （43.3％,52/120 cases）,49 cases of headache （40.8％,49/120 cases）,44 cases of vomit （36.7％,44/120 cases）,33 cases of dizziness （27.5％,33/120 cases）,24 cases of oliguria （20.0％,24/120 cases）.3.Seventy-seven patients （64.2％,77/120 cases） were renal hypertension,22 patients （18.3％,22/120 cases） were drug-induced hypertension,5 patients （4.2％,5/120 cases） were endocrine disease,4 patients （3.3％,4/120 cases） were rheumatic disease,3 patients （2.5 ％,3/120 cases） were cardiogenic disease,2 patients （1.7 ％,2/120 cases） were neuroblastoma.4.Seventy-one patients （59.2％,71/120 cases）were complicated with hypertensive encephalopathy,among them 47 patients （66.2％,47/77 cases）were acute glomerulonephritis.5.One hundred and eleven patients＇ blood pressure turned to normal after treatment of the primary diseases.The other 9 patients were discharged because they abandoned treatment.Conclusions Renal disease is the most common etiology of secondary hypertension in children.Children with secondary hypertension are easily complicated with hypertensive encephalopathy.The key of treatment is early diagnosis and early treatment of primary diseases.