Patzer Ludwig, Seeman Tomas, Luck Carmen, Wühl Elke, Janda Jan, Misselwitz Joachim
Departments of Pediatrics and Nuclear Medicine, Friedrich-Schiller-University, Jena, Germany.
J Pediatr. 2003 Feb;142(2):117-22. doi: 10.1067/mpd.2003.13.
We used 24-hour ambulatory blood pressure measurement (ABPM) to screen for early changes in children with renal scarring compared with healthy controls, and we investigated correlations between the extent of renal damage and blood pressure (BP). Study design Untreated patients (n = 61) with renal scars associated with recurrent urinary tract infection and vesico-ureteric reflux were investigated and compared with 904 healthy controls.
A significant positive correlation between the extent of renal scarring and systolic and diastolic BP standard deviation score (SDS) was found by using ABPM. Mean systolic day-time BP SDS in ABPM was significantly elevated in girls with renal scars compared with healthy controls, but failed to be significant in boys. Mean systolic and diastolic night-time BP SDS were significantly elevated in patients. Compatible with these results, diastolic dipping was significantly lower in patients compared with controls.
The increase in BP obtained by ABPM is positively correlated with the degree of scarring in our group of patients. Elevated night-time BP might be the most sensitive indicator of BP elevation in these children.
我们采用24小时动态血压监测（ABPM）来筛查肾瘢痕患儿与健康对照相比的早期变化，并研究肾损伤程度与血压（BP）之间的相关性。研究设计 对61例与复发性尿路感染和膀胱输尿管反流相关的肾瘢痕未治疗患者进行调查，并与904例健康对照进行比较。
通过ABPM发现肾瘢痕程度与收缩压和舒张压标准差评分（SDS）之间存在显著正相关。与健康对照相比，肾瘢痕女孩ABPM中平均日间收缩压SDS显著升高，但男孩中未达到显著水平。患者的平均收缩压和舒张压夜间SDS显著升高。与这些结果一致，患者的舒张压谷值与对照相比显著降低。
在我们的患者组中，通过ABPM获得的血压升高与瘢痕程度呈正相关。夜间血压升高可能是这些儿童血压升高的最敏感指标。
