Yang Zhiyong, Huang Yanyun, Qin Yan, Pang Yusheng
Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Front Pediatr. 2021 Apr 7;9:620158. doi: 10.3389/fped.2021.620158. eCollection 2021.
The aim of this study was to investigate the clinical characteristics and factors associated with pediatric hypertension and target organ damage (TOD). We retrospectively reviewed clinical data from 205 children with hypertension treated in our hospital from 2007 to 2018. The patients were classified based on the type of hypertension (primary, secondary) and presence of TOD (heart, brain, retina). Logistic regression analysis was performed to identify the factors independently associated with hypertension and TOD. There were 107 males, 97 females, and one intersex in this study, with an age range of 0.1-17.9 years. Majority of cases (177, 86.3%) had secondary hypertension, while 13.7% had primary hypertension. The most frequent cause of secondary hypertension was renal disease (59.32%). Elevated serum creatinine level (odds ratio [OR] = 7.22, 95% confidence interval [95% CI] = 1.6-32.62, = 0.01), blood urea nitrogen (OR = 6.33, 95% CI = 1.81-22.19, = 0.004), serum uric acid level (OR = 3.66, 95% CI = 1.20-11.22, = 0.023), and albuminuria (OR = 3.72, 95% CI = 1.50-9.26, = 0.005) were independently associated with secondary hypertension. Elevated serum uric acid and blood urea nitrogen levels were associated with left ventricular hypertrophy (OR = 6.638, 95% CI = 1.349-32.657, = 0.02) and hypertensive encephalopathy (OR = 4.384, 95% CI = 1.148-16.746, = 0.031), respectively. Triglyceride level correlated with hypertensive retinopathy ( = 0.001). Pediatric hypertension was most often secondary, with renal disease as the leading cause. Elevated levels of serum uric acid, blood urea nitrogen, serum creatinine, and albuminuria may indicate secondary hypertension in childhood. Elevated serum uric acid, blood urea nitrogen, and triglyceride levels were associated with left ventricular hypertrophy, hypertensive encephalopathy, and hypertensive retinopathy, respectively.
本研究的目的是调查儿童高血压及靶器官损害（TOD）的临床特征和相关因素。我们回顾性分析了2007年至2018年在我院接受治疗的205例高血压患儿的临床资料。根据高血压类型（原发性、继发性）和TOD情况（心脏、脑、视网膜）对患者进行分类。采用逻辑回归分析确定与高血压和TOD独立相关的因素。本研究中有107例男性、97例女性和1例两性畸形患者，年龄范围为0.1至17.9岁。大多数病例（177例，86.3%）为继发性高血压，而13.7%为原发性高血压。继发性高血压最常见的病因是肾脏疾病（59.32%）。血清肌酐水平升高（比值比[OR]=7.22，95%置信区间[95%CI]=1.6 - 32.62，P = 0.01）、血尿素氮（OR = 6.33，95%CI = 1.81 - 22.19，P = 0.004）、血清尿酸水平（OR = 3.66，95%CI = 1.20 - 11.22，P = 0.023）和蛋白尿（OR = 3.72，95%CI = 1.50 - 9.26，P = 0.005）与继发性高血压独立相关。血清尿酸和血尿素氮水平升高分别与左心室肥厚（OR = 6.638，95%CI = 1.349 - 32.657،P = 0.02）和高血压脑病（OR = 4.384，95%CI = 1.148 - 16.746，P = 0.031）相关。甘油三酯水平与高血压视网膜病变相关（P = 0.001）。儿童高血压最常见的是继发性，肾脏疾病是主要原因。血清尿酸、血尿素氮、血清肌酐和蛋白尿水平升高可能提示儿童继发性高血压。血清尿酸、血尿素氮和甘油三酯水平升高分别与左心室肥厚、高血压脑病和高血压视网膜病变相关。
