McNiece Karen L, Portman Ronald J
Department of Pediatrics, Division of Pediatric Nephrology and Hypertension, University of Texas - Houston, School of Medicine, Houston, Texas 77057, USA.
Curr Opin Pediatr. 2007 Apr;19(2):178-82. doi: 10.1097/MOP.0b013e328014671d.
Ambulatory blood pressure monitoring is a useful tool for the evaluation and management of hypertension in children and adolescents. This review provides a basic overview of ambulatory blood pressure monitoring and summarizes the most recent available knowledge regarding its use in the pediatric population.
Evaluation and validation of ambulatory blood pressure monitoring equipment in children remains limited, although advances in the interpretation of results for this age group have been reported specifically in the area of circadian (24 h) and ultradian (<24 h) variability. Blood pressure is a dynamic phenomenon that varies not only with time but also with changing patient and environmental circumstances. Growing evidence regarding conditions identified when this variability is considered, specifically white coat and masked hypertension, suggests that office blood pressure measurement may not be a sufficient screening test for hypertension-related target-organ damage.
Information regarding ambulatory blood pressure monitoring use in children is increasing, although due to its limitations and expense, it remains a tool primarily utilized by the pediatric sub-specialist.
动态血压监测是评估和管理儿童及青少年高血压的有用工具。本综述提供了动态血压监测的基本概述,并总结了有关其在儿科人群中应用的最新知识。
尽管在昼夜(24小时)和超昼夜(<24小时)变异性方面,已专门报道了该年龄组结果解读的进展,但儿童动态血压监测设备的评估和验证仍然有限。血压是一种动态现象,不仅随时间变化,还随患者和环境情况的改变而变化。越来越多的证据表明,考虑到这种变异性时所识别出的情况,特别是白大衣高血压和隐匿性高血压,提示诊室血压测量可能不足以筛查与高血压相关的靶器官损害。
关于儿童动态血压监测应用的信息正在增加,尽管由于其局限性和费用问题,它仍然是主要由儿科专科医生使用的工具。