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[儿童期动脉高血压。对一个学校人群的研究]

[Arterial hypertension in childhood. Study of a school population].

作者信息

Genova R, Cappellini T, Guerra A, Amore F, Lalla M

出版信息

Pediatr Med Chir. 1984 Jul-Aug;6(4):497-508.

PMID:6533596
Abstract

Most Authors fix the upper limits of normal blood pressure at 90 degrees percentile according to age. Nevertheless in their investigations different instruments were used and they often didn't relate in detail the position of the subject during the measurement. Other factors, influencing blood pressure values, have been often left out: relation with meals, room temperature, pain, drugs, stress, etc. The prevalence of hypertension in pediatric age in literature is 0,6 - 12,4% with several intermediate values. The first very important research concerning the hypertension in pediatric age was carried out by Londe et Coll., conducted among 1593 children (785 males and 798 females); they estimated mean values and percentiles according to age and sex. In the present study the A.A. saw 346 children (161 females and 185 males), 11-15 years old, observed at school, in a comfortable room. Pressure measurement was done twice in the same morning with half an our interval. Systolic pressure, 4 degrees and 5 degrees Korotkoff tones, was noticed. 11% of the children had systolic pressure values under 50 degrees percentile, 35,3% between 50 degrees and 90 degrees percentile and 43,1% had values equal or greater than 90 degrees percentile at the first measurement. The third group went down to 30,6% (106 cases) at the control (after an half an hour). This reduction shows the importance of the emotional factors in the P.A. variations. The 106 children who had systolic and/or diastolic values equal or greater than 90 degrees percentile were controlled again after a week. 92 maintained the same values. They were called for the third sitting 1-6 months later. 45 subjects agreed to our invitation and it was possible to point out that high blood pressure values persisted in 31 children (that is 8,9% of all examined cases). Following correlations were observed: body weight-blood pressure values (either systolic or diastolic ones) and so cutaneous plica-pressure values (p less than 0,01); moreover 50% of the 31 hypertensive children had hypertensive parents; the most frequent subjective symptom (13 cases) was cephalalgia. None of the studied school children showed either clinic or biochemical abnormal data, so that it was possible to define their hypertension as "essential".

摘要

大多数作者根据年龄将正常血压上限设定在第90百分位数。然而,在他们的研究中使用了不同的仪器,而且他们常常没有详细说明测量过程中受试者的姿势。其他影响血压值的因素常常被忽略:与饮食的关系、室温、疼痛、药物、压力等。文献中儿童期高血压的患病率为0.6% - 12.4%,还有几个中间值。关于儿童期高血压的第一项非常重要的研究是由隆德等人进行的,在1593名儿童(785名男性和798名女性)中开展;他们根据年龄和性别估算了平均值和百分位数。在本研究中,作者观察了346名11至15岁的儿童(161名女性和185名男性),在学校一个舒适的房间里进行观察。在同一天上午,间隔半小时测量两次血压。记录收缩压以及柯氏音第4相和第5相。在第一次测量时,11%的儿童收缩压值低于第50百分位数,35.3%的儿童收缩压值在第50百分位数至第90百分位数之间,43.1%的儿童收缩压值等于或高于第90百分位数。在半小时后的复测中,第三组降至30.6%(106例)。这种下降表明了情绪因素在血压变化中的重要性。对收缩压和/或舒张压值等于或高于第90百分位数的106名儿童在一周后再次进行检查。92名儿童维持了相同的血压值。1至6个月后,他们被要求进行第三次检查。45名受试者接受了我们的邀请,结果发现31名儿童(即所有检查病例的8.9%)的高血压值持续存在。观察到以下相关性:体重与血压值(收缩压或舒张压)以及皮肤皱襞与血压值(p < 0.01);此外,31名高血压儿童中有50%的父母患有高血压;最常见的主观症状(13例)是头痛。所研究的在校儿童均未表现出临床或生化异常数据,因此可以将他们的高血压定义为“原发性”。

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