Koch V H, Furusawa E A, Ignes E, Okay Y, Mion Junior D
Pediatric Nephrology Unit, Children's Hospital, General Hospital of the University of São Paulo School of Medicine, São Paulo, Brazil.
Blood Press Monit. 1999 Oct;4(5):213-6.
Background Ambulatory blood pressure monitoring (ABPM) has been shown to be more representative of blood pressure levels in adult patients than are casual measurements of blood pressure.
To evaluate, by means of ABPM, the behavior of blood pressure in children with chronic renal failure submitted to continuous ambulatory peritoneal dialysis and compare the results with casual blood pressure monitoring measurements.
Evaluation of blood pressures in chronically dialyzed pediatric patients by ABPM.
Ten pediatric patients, treated by continuous ambulatory peritoneal dialysis were evaluated by ABPM using the oscillometric SpaceLabs 90207 monitor, every 10 min during the day and every 15 min during the night, for 24h.
Six of 10 patients were found normotensive by office measurement of blood pressure; four of 10 patients were found hypertensive by casual measurements of blood pressure. With ABPM we obtained a mean success rate of 92.5%, confirmed hypertension in all the patients classified hypertensive in terms of office readings and reclassified six of six patients from normotensive to hypertensive. The mean systolic and diastolic physiologic falls in blood pressure at night were respectively by 10 and 15%. At the time of the ABPM study end-organ damage was present in two patients judged to be normotensive in terms of office blood pressures.
Casual recordings of blood pressure are not representative of average blood pressure in dialyzed pediatric patients. ABPM seems to be a useful diagnostic aid for assessing treatment of hypertension in children with end-stage renal disease.
动态血压监测（ABPM）已被证明比偶尔测量血压更能代表成年患者的血压水平。
通过动态血压监测评估接受持续非卧床腹膜透析的慢性肾衰竭儿童的血压情况，并将结果与偶尔测量血压进行比较。
通过动态血压监测评估长期透析的儿科患者的血压。
使用示波法SpaceLabs 90207监测仪，对10例接受持续非卧床腹膜透析治疗的儿科患者进行动态血压监测，白天每10分钟测量一次，夜间每15分钟测量一次，共24小时。
通过诊室血压测量，10例患者中有6例血压正常；通过偶尔测量血压，10例患者中有4例血压升高。通过动态血压监测，我们获得了92.5%的平均成功率，证实了所有根据诊室读数分类为高血压的患者患有高血压，并将6例血压正常的患者中的6例重新分类为高血压。夜间血压的平均收缩压和舒张压生理性下降分别为10%和15%。在动态血压监测研究时，两名根据诊室血压判断为血压正常的患者存在终末器官损害。
偶尔记录的血压不能代表透析儿科患者的平均血压。动态血压监测似乎是评估终末期肾病儿童高血压治疗的有用诊断辅助手段。
