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高血压对儿童心血管结构和功能早期变化的影响:一项病例对照研究

[Impacts of hypertension on early changes of cardiovascular structure and function among children: a case-control study].

作者信息

Liu Qin, Dong Hongbo, Meng Linghui, Cheng Hong, Yan Yinkun, Liu Junting, Mi Jie

机构信息

Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China.

Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China; Graduate School of Peking Union Medical College.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Apr;36(4):332-6.

PMID:25975544
Abstract

OBJECTIVE

To assess the cardiovascular structure and function in children with confirmed primary hypertension, and to explore the impact of hypertension and related risk factors on cardiovascular structure and function of children.

METHODS

Parameters related to cardiac structure, vascular structure and function were measured in 213 hypertensive children, who were confirmed upon repeated measurements on separate occasions. A total of 197 healthy children were recruited as controls.

RESULTS

  1. In hypertensive children, left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd), left ventricular mass (LVM), left ventricular mass index (LVMI), left ventricular posterior wall thickness (LVPT) and interventricular septal thickness (IVST) were all significantly higher than their counterparts (P < 0.05). No statistical differences were found in carotid intima-media thickness (cIMT), relative wall thickness (RWT) and brachial ankle pulse wave velocity (ba-PWV). 2) Compared with controls, LVEDd, LVESd, LVM, LVMI were all significantly higher in hypertensive children (P < 0.05), regardless of age group or weight-status. No statistical differences were found in ccIMT and RWT, while ba-PWV was statistically higher in controls among children aged 6-12 years. 3) Data from multiple linear regression analysis noticed that LVMI was associated with age, sex, BMI and hypertension while RWT was associated with age and BMI.

CONCLUSION

In children with primary hypertension, changes of vascular structure and function were not shown but left ventricular remodeling and early changes of function had been developed in children under 12 years old.

摘要

目的

评估确诊为原发性高血压儿童的心血管结构和功能,并探讨高血压及相关危险因素对儿童心血管结构和功能的影响。

方法

对213例高血压儿童进行了心脏结构、血管结构和功能相关参数的测量,这些儿童经多次独立测量确诊。共招募197例健康儿童作为对照。

结果

1)高血压儿童的左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室质量(LVM)、左心室质量指数(LVMI)、左心室后壁厚度(LVPT)和室间隔厚度(IVST)均显著高于对照组(P<0.05)。颈动脉内膜中层厚度(cIMT)、相对壁厚度(RWT)和臂踝脉搏波速度(ba-PWV)无统计学差异。2)与对照组相比,高血压儿童的LVEDd、LVESd、LVM、LVMI均显著更高(P<0.05),无论年龄组或体重状况如何。ccIMT和RWT无统计学差异,而6-12岁儿童中对照组的ba-PWV在统计学上更高。3)多元线性回归分析数据显示,LVMI与年龄、性别、BMI和高血压有关,而RWT与年龄和BMI有关。

结论

在原发性高血压儿童中,未显示血管结构和功能的变化,但12岁以下儿童已出现左心室重塑和早期功能改变。

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