Hou Miao, Sun Ling, Zhou Wan-Ping, Ding Yue-Yue, Xu Qiu-Qin, Cao Lei, Shen Jie, Yang Dao-Ping, Lyu Hai-Tao
Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu 215000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Feb;23(2):174-179. doi: 10.7499/j.issn.1008-8830.2009061.
To evaluate the condition of subclinical cardiac damage in children with primary hypertension and the association between serum uric acid and subclinical cardiac damage.
A retrospective analysis was performed on the medical data of 55 children who were hospitalized and diagnosed with primary hypertension in the Department of Cardiology, Children's Hospital of Soochow University from January 2015 to June 2020. Forty-five healthy children, matched for age and sex, were enrolled as the control group. The two groups were compared in terms of clinical features, laboratory examination, and parameters for left ventricular structure, systolic function, and diastolic function. The correlation of serum uric acid with the parameters for left ventricular structure, systolic function, and diastolic function in children with primary hypertension was analyzed.
Compared with the control group, the hypertension group had significantly higher left ventricular mass (LVM), left ventricular mass index (LVMI), and relative wall thickness (RWT) ( < 0.05). Among the children with primary hypertension, 20 (36%) had left ventricular hypertrophy. The hypertension group had significantly larger left atrial diameter and aortic root diameter than the control group ( < 0.05). The hypertension group had a significantly higher ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity than the control group ( < 0.05). The correlation analysis showed that in children with primary hypertension, serum uric acid was positively correlated with LVM (=0.534, < 0.01), left atrial diameter (=0.459, < 0.01), and aortic root diameter (=0.361, =0.010). After adjustment for blood pressure, serum uric acid was still positively correlated with the above parameters ( < 0.05).
Children with primary hypertension may have subclinical cardiac damage such as left ventricular hypertrophy, left ventricular diastolic dysfunction, left atrial enlargement, and proximal aortic dilation. Elevated serum uric acid is significantly associated with cardiac damage in children with primary hypertension.
评估原发性高血压患儿亚临床心脏损害情况以及血清尿酸与亚临床心脏损害之间的关联。
对2015年1月至2020年6月在苏州大学附属儿童医院心内科住院并诊断为原发性高血压的55例患儿的病历资料进行回顾性分析。选取45例年龄、性别相匹配的健康儿童作为对照组。比较两组的临床特征、实验室检查以及左心室结构、收缩功能和舒张功能参数。分析原发性高血压患儿血清尿酸与左心室结构、收缩功能和舒张功能参数的相关性。
与对照组相比,高血压组的左心室质量(LVM)、左心室质量指数(LVMI)和相对室壁厚度(RWT)显著更高(<0.05)。在原发性高血压患儿中,20例(36%)有左心室肥厚。高血压组的左心房内径和主动脉根部内径显著大于对照组(<0.05)。高血压组舒张早期二尖瓣血流速度与舒张早期二尖瓣环速度之比显著高于对照组(<0.05)。相关性分析显示,在原发性高血压患儿中,血清尿酸与LVM(=0.534,<0.01)、左心房内径(=0.459,<0.01)和主动脉根部内径(=0.361,=0.010)呈正相关。校正血压后,血清尿酸仍与上述参数呈正相关(<0.05)。
原发性高血压患儿可能存在左心室肥厚、左心室舒张功能障碍、左心房扩大和主动脉近端扩张等亚临床心脏损害。血清尿酸升高与原发性高血压患儿的心脏损害显著相关。