Hooman Nakysa, Isa-Tafreshi Roya, Mostafavi Seyed-Hassan, Hallaji Farideh, Tavasoli Azita, Otukesh Hasan
Department of Pediatric Nephrology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran -
Department of Pediatric Cardiology, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Minerva Pediatr. 2017 Jun;69(3):200-205. doi: 10.23736/S0026-4946.16.04217-1.
Hypertension (HTN) is a late outcome of congenital or acquired renal scar. We used ambulatory blood pressure to assess the early blood pressure abnormalities in children with history of urinary tract infection with various degrees of renal scars.
Between 2009 and 2011, 60 (45 females, 15 males) children aged 5-15 years and height equal or more than 120 cm with previous history of febrile urinary tract infection were entered into the study. All children went on 24-hour ambulatory blood pressure monitoring (24-H ABPM). Updated classification of 24-H ABPM was used to interpret the results.
Masked hypertension was detected in 5% of cases, hypertension in 8.4%, and white coat hypertension in 11.7%. Pre-hypertension was seen in 23.3% of children. There was significant correlation between abnormal blood pressure and the severity of renal parenchymal scar (r=0.39, P value=0.004), vesicoureteral reflux (r= 0.34, P value=0.009), microalbuminuria (r= 0.39, P value=0.004), and carotid intima media thickness (r=0.41, P value=0.006).
This study revealed the utility of 24-H ABPM in early detection of hypertension and pre-hypertension in children with severe renal scars and past history of urinary tract infection.
高血压（HTN）是先天性或后天性肾瘢痕的晚期结局。我们采用动态血压来评估有不同程度肾瘢痕的尿路感染患儿早期的血压异常情况。
在2009年至2011年期间，60名（45名女性，15名男性）年龄在5至15岁且身高等于或超过120厘米、有发热性尿路感染病史的儿童进入本研究。所有儿童均进行了24小时动态血压监测（24-H ABPM）。采用24-H ABPM的更新分类来解释结果。
5%的病例检测到隐匿性高血压，8.4%为高血压，11.7%为白大衣高血压。23.3%的儿童有高血压前期表现。血压异常与肾实质瘢痕严重程度（r=0.39，P值=0.004）、膀胱输尿管反流（r=0.34，P值=0.009）、微量白蛋白尿（r=0.39，P值=0.004）以及颈动脉内膜中层厚度（r=0.41，P值=0.006）之间存在显著相关性。
本研究揭示了24-H ABPM在早期检测有严重肾瘢痕和尿路感染病史儿童的高血压及高血压前期方面的作用。
