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住院高血压患儿的病因及用药:一项回顾性研究

Etiology and Medication of Hospitalized Children With Hypertension: A Retrospective Study.

作者信息

Jia Chenhong, Ding Weijing, Ding Xiangyu

机构信息

Department of Pharmacy, Hebei Children's Hospital, Shijiazhuang, Hebei Province, China.

出版信息

J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14923. doi: 10.1111/jch.14923. Epub 2024 Nov 4.

Abstract

With the increasing incidence of hypertension in children, the lack of high-quality research data on antihypertensive drugs in pediatric patients restricts treatment options for clinicians and can lead to suboptimal outcomes. We conducted a retrospective analysis of clinical data from hospitalized pediatric patients diagnosed with hypertension and treated with antihypertensive drugs in the past 3 years. The study included 203 pediatric patients (119 males and 84 females), with an average age of 8.9 ± 4.7 years (range: 0.1-17 years). Clinical symptoms of hypertension were observed in 132 participants (65.0%), and the conditions in all cases were classified as primary or secondary hypertension. Renal causes (71 patients, 35.0%) and drug-induced factors (39 patients, 19.2%) were the main causes of secondary hypertension. Nifedipine (137 patients, 67.5%) was the most commonly prescribed medication, followed by captopril (84 patients, 41.4%). Multiple antihypertensive medications were prescribed to 99 participants (48.8%), and blood pressure returned to normal in 111 patients (54.7%). Hypertension-related organ damage was observed in 47 patients (23.2%). Timely diagnosis and treatment of hypertension are critical to prevent organ damage in pediatric patients. Although nifedipine was widely used in this pediatric cohort, the appropriateness of this treatment remains unclear. Emphasis should be placed on monitoring target organs affected by pediatric hypertension, and post-discharge antihypertensive treatment should include thorough follow-ups and documentation.

摘要

随着儿童高血压发病率的不断上升,缺乏关于儿科患者抗高血压药物的高质量研究数据限制了临床医生的治疗选择,并可能导致治疗效果欠佳。我们对过去3年中诊断为高血压并接受抗高血压药物治疗的住院儿科患者的临床资料进行了回顾性分析。该研究纳入了203例儿科患者(男119例,女84例),平均年龄为8.9±4.7岁(范围:0.1 - 17岁)。132名参与者(65.0%)观察到高血压临床症状,所有病例的病情均分为原发性或继发性高血压。肾脏原因(71例患者,35.0%)和药物诱导因素(39例患者,19.2%)是继发性高血压的主要原因。硝苯地平(137例患者,67.5%)是最常开具的药物,其次是卡托普利(84例患者,41.4%)。99名参与者(48.8%)开具了多种抗高血压药物,111例患者(54.7%)血压恢复正常。47例患者(23.2%)观察到高血压相关器官损害。及时诊断和治疗高血压对于预防儿科患者的器官损害至关重要。尽管硝苯地平在这个儿科队列中被广泛使用,但这种治疗的合理性仍不清楚。应重视监测受儿科高血压影响的靶器官,出院后的抗高血压治疗应包括全面的随访和记录。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dfe/11771796/a2db24b3bce7/JCH-27-e14923-g001.jpg

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