血压正常儿童的动态血压监测

Ambulatory blood pressure monitoring in normotensive children.

作者信息

Lurbe E, Redon J, Liao Y, Tacons J, Cooper R S, Alvarez V

机构信息

Department of Pediatrics, General Hospital, University of Valencia, Spain.

出版信息

J Hypertens. 1994 Dec;12(12):1417-23.

PMID:7706703

Abstract

OBJECTIVE

To assess reference values of ambulatory blood pressure in normotensive children.

SUBJECTS AND DESIGN

Twenty-four-hour non-invasive ambulatory blood pressure monitoring (ABPM) was carried out in 241 healthy normotensive children aged from 6 to 16 years (126 boys, mean +/- SD age 11.2 +/- 2.7 years; 115 girls, mean +/- SD age 10.9 +/- 2.9 years). The subjects were subdivided into three age-sex groups: 6-9, 10-12 and 13-16 years.

SETTING

Primary care.

MAIN OUTCOME MEASURES

ABPM was performed using an oscillometric device (SpaceLabs model 90207) and appropriate cuff size during a regular school day. Blood pressure was measured every 20 min from 0600 to 2400 h, and thereafter every 30 min. At each monitoring session the following parameters were calculated for both systolic (SBP) and diastolic blood pressure (DBP): means and centiles for 24-h, daytime (0800-2200 h) and night-time (2400-0600 h); circadian variability, estimated as the blood pressure fall between the day and the night periods and the day: night ratio; and load, as the percentage of measurements above the age- and sex-specific 95th centile (P95).

RESULTS

The upper limits of 'normality' for the mean of 24-h SBP and DBP estimated as the P95 in each age subgroup were 121/71 and 119/71 mmHg, 123/78 and 120/74 mmHg, and 124/78 and 125/75 mmHg, for boys and girls, respectively. A progressive increase in SBP with age was observed in both sexes, in contrast, DBP was similar throughout the age range. A nocturnal blood pressure fall of approximately 11 mmHg was observed for both SBP and DBP in all subgroups. The day:night ratio was 1.12 and 1.22 for SBP and DBP, respectively. The upper limit of blood pressure load, estimated as the P95 in all children, was 39% for SBP and 26% for DBP. A significant positive correlation was observed between casual blood pressure and 24-h ambulatory blood pressure (SBP: r = 0.61, P < 0.0001; DBP: r = 0.31, P < 0.0001). In general, mean ambulatory blood pressure, during the 24-h or the daytime period, was higher than casual blood pressure for both SBP and DBP.

CONCLUSION

ABPM is feasible in children, and the values obtained are useful as a departure point in establishing reference values.

摘要

目的

评估血压正常儿童的动态血压参考值。

对象与设计

对241名6至16岁的健康血压正常儿童（126名男孩，平均年龄±标准差为11.2±2.7岁；115名女孩，平均年龄±标准差为10.9±2.9岁）进行了24小时无创动态血压监测（ABPM）。受试者被分为三个年龄 - 性别组：6 - 9岁、10 - 12岁和13 - 16岁。

设置

初级保健。

主要观察指标

在正常上课日期间，使用示波装置（SpaceLabs 90207型）和合适的袖带尺寸进行ABPM。从06:00至24:00每20分钟测量一次血压，之后每30分钟测量一次。在每次监测期间，计算收缩压（SBP）和舒张压（DBP）的以下参数：24小时、白天（08:00 - 22:00）和夜间（24:00 - 06:00）的平均值和百分位数；昼夜变异性，以白天和夜间血压下降以及昼夜比来估计；负荷，即高于年龄和性别特异性第95百分位数（P95）的测量值百分比。

结果

各年龄亚组中，以P95估计的24小时SBP和DBP平均值的“正常”上限，男孩分别为121/71和119/71 mmHg，女孩分别为123/78和120/74 mmHg，以及124/78和125/75 mmHg。观察到两性的SBP均随年龄逐渐升高，相比之下，DBP在整个年龄范围内相似。所有亚组的SBP和DBP夜间血压下降约11 mmHg。SBP和DBP的昼夜比分别为1.12和1.22。所有儿童中以P95估计的血压负荷上限，SBP为39%，DBP为26%。偶然血压与24小时动态血压之间观察到显著正相关（SBP：r = 0.61，P < 0.0001；DBP：r = 0.31，P < 0.0001）。一般来说，24小时或白天期间的平均动态血压，SBP和DBP均高于偶然血压。