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对有极早产史的学龄儿童进行动态血压监测。

Ambulatory blood pressure monitoring in school children with a history of extreme prematurity.

作者信息

Solís Andrea, Cerda Jaime, González Claudia

机构信息

Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile.

Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Chil Pediatr. 2018 Feb;89(1):18-23. doi: 10.4067/S0370-41062018000100018.

Abstract

INTRODUCTION

Extremely premature children have a higher incidence of High Blood Pressure (HBP) and risk of renal damage due to decreased glomerular count with consequent hyperfiltration of the remnants.

OBJECTIVES

To assess the prevalence of altered blood pressure values in outpatient measurement and ambulatory blood pressure monitoring (ABPM) in preterm infants ≤ 32 weeks and/ or ≤ 1,500 g birth weight between 5 and 7 years of age, as well as the presence of early renal damage markers.

PATIENTS AND METHODS

An isolated measurement of blood pressure, ABPM and laboratory tests (microalbuminuria/creatininuria ratio in an isolated urine sample, serum creatinine, blood urea nitrogen and urinalysis) were performed.

RESULTS

30 patients were recruited, of whom valid measu rements of ABPM were obtained in 19 cases, of which nine (47,4%) presented some abnormalities, principally nocturnal day/night difference or DIP absent. No abnormal laboratory tests were found.

DISCUSSION

Our study detected a high prevalence of abnormalities in ABPM principally DIP absence, which has been related to an increased risk of progression to hypertension. The importance of per forming ABPM in the study is emphasized in patients with risk factors for developing hypertension in order to detect early alterations and close management and follow-up.

摘要

引言

极早产儿患高血压(HBP)的发生率较高,且由于肾小球数量减少导致残余肾小球超滤,存在肾损伤风险。

目的

评估出生体重≤32周和/或≤1500克的早产儿在5至7岁时门诊测量和动态血压监测(ABPM)中血压值改变的患病率,以及早期肾损伤标志物的存在情况。

患者与方法

进行了一次血压单独测量、ABPM和实验室检查(单独尿液样本中的微量白蛋白尿/肌酐尿比值、血清肌酐、血尿素氮和尿液分析)。

结果

招募了30名患者,其中19例获得了有效的ABPM测量值,其中9例(47.4%)出现了一些异常,主要是夜间昼夜差异或无谷峰差。未发现异常实验室检查结果。

讨论

我们的研究发现ABPM异常的患病率很高,主要是无谷峰差,这与进展为高血压的风险增加有关。对于有高血压危险因素的患者,强调在研究中进行ABPM的重要性,以便检测早期改变并进行密切管理和随访。

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