苏州市儿童青少年身高别血压筛查简表的效果评价

Validation of a simplified height-specific blood pressure table for screening high blood pressure among children and adolescents in Suzhou

目的基于苏州市7~17岁儿童青少年评价身高别血压筛查简表的效果,为制定儿童青少年血压综合防控策略和措施提供参考。方法采用分层整群随机抽样方法,2017-2018年抽取苏州市7~17岁学生6972名,进行问卷调查,测量其身高、体重和血压。依据《7~18岁儿童青少年血压偏高筛查界值(WS/T 610-2018)》为"金标准",评价根据金标准建立的身高别血压筛查简表筛查正常血压高值和血压偏高的效果。结果根据金标准和身高别血压筛查简表,苏州7~17岁儿童青少年正常血压高值检出率分别为16.7%和16.6%,血压偏高检出率分别为12.7%和12.8%;配对χ2检验显示两标准评价效果差异无统计学意义(χ^(2)=1.376,P=0.711)。与金标准相比,身高别血压筛查简表筛查正常血压高值,血压偏高具有较好的一致性。筛查正常血压高值的受试者工作特征曲线下面积(95%置信区间)、灵敏度、特异度和Kappa值分别为0.900(0.887~0.913)、83.2%、96.8%和0.803,对应的筛查血压偏高值分别为0.925(0.911~0.938)、86.9%、98.0%和0.848。结论身高别血压筛查简表使用方便,筛查正常血压高值和血压偏高效果很好。

Objective To validate a Simplified Height Specific Blood Pressure(BP)Table for screening high blood pressure(HBP)among children and adolescents in Suzhou,in order to provide reference for making strategies for preventing childhood HBP.Methods A total of 6972 children and adolescents aged 7 to 17 years were selected in this study by stratified cluster random sampling method from 2017 to 2018,and were asked to fill out questionnaires,meanwhile their height,weight and BP were measured.According to Chinese Blood Pressure Reference for Children and Adolescents aged 7-18 years(WS/T 610-2018)(hereafter referred to as"gold standard"),a simplified height specific BP table was developed.Validation of HBP and high normal BP(HNBP)was assessed.Results According to gold standard and simplified height specific BP table,the detection rates of HNBP in children and adolescents aged 7 to 17 years in Suzhou were 16.7%and 16.6%,respectively,and the detection rate of HBP was 12.7%and 12.8%.Paired chi-square test showed that there was no significant difference on the prevalence of HNBP and HBP identified by two standards(χ^(2)=1.376,P=0.711).Performance of simplified height specific BP table was in good agreement with gold standard.When screening HNBP,the area under the curve(95%CI),sensitivity,specificity and Kappa value were 0.900(0.887-0.913),83.2%,96.8%,and 0.803,respectively.And corresponding values for screening HBP were 0.925(0.911-0.938),86.9%,98.0%,and 0.848,respectively.Conclusion Simplified height specific BP table is easy to use,and it shows satisfying effect for screening HNBP and HBP.