中国实用儿科杂志

中国实用儿科杂志

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儿童直立性高血压的临床特征及其分型研究

  

  1. 1.北京大学第一医院儿科，北京  100034；2.河西学院医学院，甘肃  张掖  734000
  • 出版日期:2017-08-06 发布日期:2017-07-28

Clinical characteristics and typing of orthostatic hypertension in children

  1. *Department of Pediatrics，Peking University First Hospital，Beijing  100034，China
  • Online:2017-08-06 Published:2017-07-28

摘要：

目的    探讨儿童直立性高血压（OHT）的发病情况及临床特征。方法　收集2009—2015年在北京大学第一医院儿科住院的以晕厥、头晕等为主要表现的1348例儿童的病例资料，检出OHT患儿24例，分析其人口学特征、各种临床表现的发生率、诱发因素及卧立位血压变化情况。结果　（1）OHT男14例，女10例，男女患病率 ≤ 12岁者与＞12岁者所占比例差异均无统计学意义；（2）直立性高收缩压（sOHT）与直立性高舒张压（dOHT）≤12岁者与＞12岁者所占比例、男女所占比例差异均无统计学意义；（3）就诊时最常见的症状为晕厥、头晕、胸闷等，其中发生晕厥和胸闷症状者以dOHT患儿居多，sOHT与dOHT患儿出现头晕症状者比例相当；多在患儿突然体位变化（41.7%）或持久站立（37.5%）、持久坐位（37.5%）时发生；其中持久站立和持久坐位是诱发sOHT的主要原因，而突然体位变化是dOHT的主要诱因。结论　OHT患儿发病与分型均不存在年龄及性别差异，以晕厥、头晕和胸闷为主要临床症状；持久站立和持久坐位是诱发sOHT的主要原因，而突然体位变化是dOHT的主要诱因。

关键词: 儿童, 直立性高血压, 发病率, 临床特征, 分型

Abstract:

Objective　To investigate the incidence and clinical characteristics of orthostatic hypertension（OHT）in children. Methods　Totally 1348 children with syncope，dizziness，etc，were collected in Peking University First Hospital between 2009 and 2015，24 of whom were diagnosed with OHT. Demographic characteristics，the occurrence frequency of various clinical manifestations and its inducing factors，course of disease and the changes of the blood pressure at the lying position were analysed. Results　（1）Among 1348 children，OHT was in 24 （male 14，female 10）. The case proportions of those at or under 12 years old to those beyound 12 years old and the ratio of male to female showed no significant differences.（2）There was no difference between those at or younger than 12 years old and those older than 12 years old（χ2＝0.411，P＝0.521），or the ratio of males to females in sOHT and dOHT. （3）The most common clinical manifestations were syncope，dizziness，chest tightness，and so on. Syncope and chest tightness mostly appeared in dOHT children. The incidence of dizeiness in sOHT and dOHT was similar. In children，common inducements were sudden postural changes（from supine to upright and standing position）（41.7%），persistent standing（37.5%），or persistent seating（37.5%）. Persistent standing and persistent seating were the main cause of sOHT. Sudden postural changes were the main cause of dOHT. Conclusion　There is no age or gender difference in the incidence and typing of OHT in children. Syncope，dizziness and chest tightness are the main clinical manifestations. Persistent standing and persistent seating are the main cause of sOHT. Sudden postural changes are the main cause of dOHT.

Key words: child, orthostatic hypertension, incidence, clinical manifestation, typing