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[中国儿童青少年高血压筛查简化身高特异性血压界值表的制定与验证]

[Development and validation of a simplified height-specific blood pressure cutoffs table for screening hypertension in Chinese children and adolescents].

作者信息

Hou Y P, Liu Q, Yang L, Zhao M, Zong X N, Xi B

机构信息

Department of Epidemiology, School of Public Health, Shandong University/Children Cardiovascular Research Center of Shandong University, Ji'nan 250012, China.

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

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2019 Jul 6;53(7):701-705. doi: 10.3760/cma.j.issn.0253-9624.2019.07.009.

Abstract

To develop and validate a simplified height-specific blood pressure cutoffs table for screening hypertension in Chinese children and adolescents. We developed a simplified height-specific blood pressure cut offs table according to Chinese Blood Pressure Reference for Children and Adolescents aged 7-18 years (WS/T 610-2018) (hereafter referred to as "complex definition"). Populations from Early Warning, Diagnosis and Treatment of Children Cardiovascular Disease Project ("Ji'nan sample") and Shandong Children Cardiovascular Cohort Study Project ("Zibo sample") were used as validation populations for evaluating the screening effect of the simplified table for elevated blood pressure and hypertension in children and adolescents. We developed simplified height-specific blood pressure cutoffs table including 7 height groups and 28 cutoffs. Both Ji'nan and Zibo samples were selected by convenient sampling method, and the former included 7 233 participants aged 7 to 17 years, among whom 3 790 (52.4%) were boys. Latter population included 1 277 participants aged 7 to 11 years, among whom 681 (53.3%) were boys. The simplified table performed well for identifying elevated blood pressure in Ji'nan sample, with values of area under the receiver operating curve (AUC) (95), sensitivity, specificity, and Kappa statistic as 0.96 (0.95-0.97), 93.0%, 98.5% and 0.91, respectively, which were similar with results in Zibo sample [the values were 0.92 (0.90-0.95), 87.0%, 98.0% and 0.85, respectively]. The simplified table also performed well for identifying hypertension in Ji'nan sample with values of AUC (95), sensitivity, specificity, and Kappa statistic as 0.92 (0.91-0.94), 86.9%, 98.1% and 0.85, respectively, which were similar with results in Zibo sample [the values were 0.94 (0.91-0.96), 88.2%, 98.9% and 0.88, respectively]. Screening for elevated and high blood pressure based on simplified height-specific blood pressure cutoffs table is easy to use and it shows satisfying effect.

摘要

制定并验证一个简化的按身高划分的血压临界值表,用于筛查中国儿童和青少年的高血压。我们根据《7-18岁儿童青少年血压参考标准》(WS/T 610-2018)(以下简称“复杂定义”)制定了一个简化的按身高划分的血压临界值表。将儿童心血管疾病预警、诊断与治疗项目(“济南样本”)和山东儿童心血管队列研究项目(“淄博样本”)的人群作为验证人群,以评估该简化表对儿童和青少年血压升高及高血压的筛查效果。我们制定了包含7个身高组和28个临界值的简化按身高划分的血压临界值表。济南和淄博样本均采用方便抽样法选取,前者包括7233名7至17岁的参与者,其中3790名(52.4%)为男性。后者包括1277名7至11岁的参与者,其中681名(53.3%)为男性。该简化表在济南样本中对识别血压升高的表现良好,受试者工作特征曲线下面积(AUC)(95)、灵敏度、特异度和Kappa统计量的值分别为0.96(0.95 - 0.97)、93.0%、98.5%和0.91,与淄博样本的结果相似[其值分别为0.92(0.90 - 0.95)、87.0%、98.0%和0.85]。该简化表在济南样本中对识别高血压的表现也良好,AUC(95)、灵敏度、特异度和Kappa统计量的值分别为0.92(0.91 - 0.94)、86.9%、98.1%和0.85,与淄博样本的结果相似[其值分别为0.94(0.91 - 0.96)、88.2%、98.9%和0.88]。基于简化的按身高划分的血压临界值表筛查血压升高和高血压易于使用,且显示出令人满意的效果。

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