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灾难相关创伤与幼儿血压:东日本大地震后的随访研究。

Disaster-related trauma and blood pressure among young children: a follow-up study after Great East Japan earthquake.

机构信息

Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, 02125, USA.

出版信息

Hypertens Res. 2019 Aug;42(8):1215-1222. doi: 10.1038/s41440-019-0250-6. Epub 2019 Mar 22.

Abstract

The 11 March 2011 earthquake and tsunami in Japan resulted in ~19,000 lost lives and the displacement of nearly a quarter million people owing to extensive property damage and evacuation from the nuclear meltdown in Fukushima. We sought to prospectively examine whether exposure to disaster-related trauma affected blood pressure levels among young children. We sampled children in three affected prefectures (Miyagi, Fukushima, Iwate) and one unaffected prefecture (Mie). The participants (mean age 6.6 years) and their caregivers answered a baseline survey (N = 320) and a follow-up survey 4 years after the earthquake (N = 227, follow-up rate 71%). Disaster-related trauma was assessed at the baseline, and blood pressure measurements were taken at the follow-up. We converted blood pressure data into age/sex/height-specific z-scores. In linear regression models, we controlled for body mass index, income, age, sex, and housing situation (living in the same house as before the disaster, in a shelter, or in a new house). The number of traumatic experiences was related to diastolic blood pressure in a dose-dependent manner but was not related to systolic blood pressure. Children reporting four or more traumatic experiences had marginally significant elevated diastolic blood pressure (β = 0.43, p = 0.059). Among specific types of disaster trauma, witnessing a fire was significantly related to higher diastolic blood pressure (β = 0.60, p = 0.009). In conclusion, disaster-related trauma was associated with higher diastolic blood pressure among young children 4 years after the traumatic events.

摘要

2011 年 3 月 11 日日本地震和海啸导致约 1.9 万人丧生,近 25 万人因财产损失广泛和福岛核熔毁而被迫撤离。我们旨在前瞻性地研究与灾难相关的创伤是否会影响儿童的血压水平。我们在三个受灾县(宫城、福岛、岩手)和一个未受灾县(三重)抽取了儿童样本。参与者(平均年龄 6.6 岁)及其照料者回答了基线调查(N=320)和地震 4 年后的随访调查(N=227,随访率 71%)。在基线时评估与灾难相关的创伤,在随访时测量血压。我们将血压数据转换为年龄/性别/身高特异性 z 分数。在线性回归模型中,我们控制了体重指数、收入、年龄、性别和住房情况(与灾难前住在同一所房子里、住在避难所或新房子里)。创伤经历的数量与舒张压呈剂量依赖性相关,但与收缩压无关。报告有 4 次或更多创伤经历的儿童舒张压略有升高(β=0.43,p=0.059)。在特定类型的灾难创伤中,目睹火灾与更高的舒张压显著相关(β=0.60,p=0.009)。总之,创伤事件发生 4 年后,与灾难相关的创伤与儿童的舒张压升高有关。

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