Ogborn M R, Crocker J F
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Am J Dis Child. 1987 Nov;141(11):1205-9. doi: 10.1001/archpedi.1987.04460110075026.
Using a comprehensive protocol, the efficacy of simple clinical data, including history, physical examination, and urinalysis, in the discrimination of essential or secondary hypertension was investigated by a review of 103 patients, aged 2 weeks to 18 years, consecutively referred for investigation. Essential hypertension (55/103 mm Hg) was the most common diagnosis, even in infancy, whereas various renal disorders formed the next most common diagnostic category (21/103 mm Hg). Family history and the presence of "fixed" vs "labile" hypertension were of no value in detecting secondary hypertension. Urinalysis was useful in detecting inflammatory renal lesions but not structural disorders of the kidney. This study emphasizes the need for thorough investigation, including renal imaging, of asymptomatic hypertensive children and suggests a useful protocol to achieve this end.
采用综合方案，通过对103例年龄在2周龄至18岁之间连续转诊接受检查的患者进行回顾，研究了包括病史、体格检查和尿液分析在内的简单临床数据在鉴别原发性或继发性高血压中的有效性。原发性高血压（55/103例）是最常见的诊断，即使在婴儿期也是如此，而各种肾脏疾病是第二常见的诊断类别（21/103例）。家族史以及“固定性”与“波动性”高血压的存在对检测继发性高血压没有价值。尿液分析有助于检测炎症性肾脏病变，但对肾脏结构紊乱无效。本研究强调对无症状高血压儿童进行包括肾脏影像学检查在内的全面检查的必要性，并提出了实现这一目标的有用方案。
