儿童血压正常范围探讨

ON NORMAL BLOOD PRESSURE RANGE IN CHILDREN

按统一调查方案随机择取地处国内南(贵阳、昆明、福州),中(上海城乡、武汉),北域(石家庄、天津)地区8个7～14岁儿童群共12920人,作血压调查。结果发现:舒张压频率曲线呈双峰分布;不同地区儿童血压也有差别,认为设统一正常血压标准不妥,可求得各年龄性别组的95百分位数血压值作为正常高界;青春期血压与发育状况关系大,按反映发育的体重分级优于按年龄分级;不同儿童群血压的“轨迹”意义也不同。如南方福州成人高血压患病率低而儿童期血压反高于北方石家庄和天津,故对儿童“高血压病”的诊断宜慎重。

Eight groups of 7-14 year population, amounting to 12920 children of both sexes, living scatteredly in southern (Guiyang, Kunming, Fuzhou), middle (Shanghai, Wuhan) and northern areas (Shijiazhuang, Tianjin) were enrolled randomly according to an uniform protocol for blood pressure (BP) survey in children. The results are: (1) The diastolic BP (DBP) frequency curve is shown dimodal. (2) Due to the quite large discrepancy of BP in children among diverse areas, it is relevant to select the 95th percentile values of BP for referred age-sex subgroups as the upper limit instead of adopting a fixed standard of normal BP range. (3) Because of the great influence of puberty upon BP levels, BP levels in terms of body weight reflecting the developmental status arc apparently superior to that of age. (4) The significance of 'tracking' phenomenon in different children population seems diverse, i. e., the prevalence of hypertension of Fuzhou adults in southern China is lower, whereas the BP levels in Fuzhou children are higher than those of Shijiazhuang and Tianjin in northern China. It is thus emphasized that making a diagnosis of 'essential hylpertension' in children should be made with caution.