Hu Yang, Wang Yuanyuan, He Bing, Wang Yaru, Han Zhenhui, Tao Chunyan, Li Hongxia, Jiang Yi, Tang Chaoshu, Du Junbao
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Research Unit of Clinical Diagnosis and Treatment of Pediatric Syncope and Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Front Pediatr. 2020 Feb 21;8:54. doi: 10.3389/fped.2020.00054. eCollection 2020.
There are no prior publications or submissions with any overlapping information, including studies and patients. The study data have not been presented as an abstract or poster before the submission. The study was conducted to analyze the changes of baroreflex sensitivity and heart rate variability from supine to upright standing in children and adolescents with orthostatic hypertension to explore whether and how the autonomic nerve regulation was involved in the development of pediatric orthostatic hypertension. This case-control study included twenty-five children with orthostatic hypertension (the patient group) and twenty-six healthy controls (the control group). All subjects underwent a standing test, during which their hemodynamic parameters were continuously monitored by a Finapres Medical System, and baroreflex sensitivity and heart rate variability were calculated. The demographic characteristics, supine baroreflex sensitivity, and supine heart rate variability including time domain and frequency domain indices did not differ between the patients with orthostatic hypertension and healthy subjects ( > 0.05). However, a more obvious drop of baroreflex sensitivity and a greater increase of low frequency/high frequency ratio from supine to upright were observed in subjects with orthostatic hypertension compared with those in the healthy children ( < 0.001 and < 0.01, respectively). Changes of baroreflex sensitivity were negatively related to mean arterial pressure changes from supine to upright in all subjects ( < 0.01), and the increases in low frequency/high frequency ratio from supine to standing were positively correlated with those in mean arterial pressure in the study subjects ( < 0.001). Upright sympathetic overactivation is associated with pediatric orthostatic hypertension.
没有先前发表的或提交的包含任何重叠信息的文献，包括研究和患者。在提交之前，研究数据未曾以摘要或海报形式展示过。本研究旨在分析体位性高血压儿童和青少年从仰卧位到直立位时压力反射敏感性和心率变异性的变化，以探讨自主神经调节是否以及如何参与小儿体位性高血压的发生发展。这项病例对照研究包括25名体位性高血压儿童（患者组）和26名健康对照者（对照组）。所有受试者均接受站立试验，在此期间通过Finapres Medical System连续监测其血流动力学参数，并计算压力反射敏感性和心率变异性。体位性高血压患者与健康受试者之间的人口统计学特征、仰卧位压力反射敏感性以及包括时域和频域指标在内的仰卧位心率变异性无差异（>0.05）。然而，与健康儿童相比，体位性高血压受试者从仰卧位到直立位时压力反射敏感性下降更明显，低频/高频比值增加更大（分别<0.001和<0.01）。在所有受试者中，压力反射敏感性的变化与从仰卧位到直立位时平均动脉压的变化呈负相关（<0.01），研究对象中从仰卧位到站立位时低频/高频比值的增加与平均动脉压的增加呈正相关（<0.001）。直立位交感神经过度激活与小儿体位性高血压有关。
