130例儿童原发性高血压亚临床心血管损害评估及相关因素分析

Assessment of preclinical cardiovascluar damages in children with primary hypertension

目的评估儿童原发性高血压亚临床心血管损害情况,并分析其相关因素。方法回顾性分析2006年1月至2017年12月于本院住院诊断为原发性高血压且未经治疗的130例患儿的基本临床特征和实验室检查结果,评估原发性高血压患儿发生亚临床心血管损害(包括左心室肥厚和颈动脉内-中膜厚度增厚)的相关危险因素。结果130例原发性高血压患儿中48例(36.9%)发生左心室肥厚,35例(26.9%)存在颈动脉内-中膜厚度增厚。单因素分析显示,24h平均舒张压、血尿酸及血β2微球蛋白水平升高均与原发性高血压患儿发生左心室肥厚有关(均P<0.05)。空腹C肽水平升高与原发性高血压患儿发生颈动脉内-中膜厚度增厚有关(P<0.05)。结论部分原发性高血压患儿就诊时已存在亚临床心血管损害,需加强对相关因素的监测,警惕亚临床心血管损害的发生。

Objective This study is to assess the condition of preclinical cardiovascular damages in children with primary hypertension,and to analyze relative factors of preclinical cardiovascular damages.Method With retrospective analysis,130 children who were diagnosed as primary hypertension from January 2006 to December 2017 were enrolled.Basic clinical features were recorded,and preclinical cardiovascular damages were assessed,including left ventricular hypertrophy (LVH) and increased carotid intima-media thickness (cIMT).Result There were 48 children (36.9%) with LVH among 130 hypertensive children,while there were 35 children (26.9%) with increased cIMT.Unirariate analysis showed the 24 h average diastolic pressure,blood uric acid and blood β2- microglobulin correlated with LVH in children with primary hypertension (all P < 0.05),while the inerease of fasting C-peptide was correlated with the thickening of cIMT in children with primary hypertension (P < 0.05).Conclusion Part of children with primary hypertension have preclinical cardiovascluar damages on the moment of diagnosis.Moditoring of these indexes is necessary for prediction of preclinical cardiovascular damage.