Feber Janusz, Litwin Mieczyslaw
Division of Nephrology, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, K1H 8L1, Canada.
Department of Nephrology and Hypertension, Children's Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730, Warsaw, Poland.
Pediatr Nephrol. 2016 Jul;31(7):1071-9. doi: 10.1007/s00467-015-3161-z. Epub 2015 Jul 23.
The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension.
由于儿童体型各异且不配合，血压（BP）评估颇具挑战性，尤其是对非常年幼的个体而言。在缺乏儿童血压与心血管结局相关数据的情况下，有必要将绝对血压值（以毫米汞柱为单位）转换为适合年龄、性别和身高的血压百分位数或Z分数，以便将患者的血压与同龄健康儿童以及不同年龄儿童的血压进行比较。传统上，血压的解读主要基于诊室、家庭或24小时血压监测所获得的血压水平评估。近期研究表明，不仅血压水平（即平均血压），而且血压变异性对于靶器官损害的发生发展，包括慢性肾脏病的进展，在临床上都很重要。在本综述中，我们描述了评估血压水平的当前方法，概述了可用的血压变异性评估方法，并讨论了血压变异性的临床后果，包括其在高血压管理中的潜在作用。
