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基于新生儿和婴儿双胞胎的前瞻性人群队列中的血压情况。

Blood pressure in prospective population based cohort of newborn and infant twins.

作者信息

Levine R S, Hennekens C H, Jesse M J

机构信息

Department of Family and Preventive Medicine, Meharry Medical College, Nashville, TN 37208.

出版信息

BMJ. 1994 Jan 29;308(6924):298-302. doi: 10.1136/bmj.308.6924.298.

Abstract

OBJECTIVE

To describe blood pressure in twins during infancy.

DESIGN

Prospective study of cohort of twins.

SETTING

Teaching hospital in Florida.

SUBJECTS

166 viable twin pairs born between July 1976 and December 1989.

MAIN OUTCOME MEASURES

Blood pressure and body weight at birth, at 14 days, and at 1, 3, 6, 9, and 12 months.

RESULTS

Both systolic and diastolic pressure correlated with body weight throughout infancy (at birth r = 0.41, P < 0.001 and r = 0.42, P < 0.001 respectively; at 1 year r = 0.23, P < 0.001 and r = 0.26, P < 0.001 respectively). In infants weighing < 1500 g at birth mean blood pressure rose from about 45/25 mm Hg to 101/55 mm Hg from birth to the age of 1 year, while in infants weighing > 3000 g at birth it rose from 63/39 mm Hg to 100/61 mm Hg; corresponding mean body weights at 1 year were 7.86 kg and 9.88 kg. Differences in birth weight within pairs of monozygotic twins were negatively correlated with such differences in systolic blood pressure at 1 year (r = -0.37, P < 0.01).

CONCLUSIONS

Blood pressure and body weights in twins showed strongly positive but generally declining correlations throughout infancy. Twins of lower birth weight showed a more rapid rate of rise in blood pressure during infancy. At 1 year the catch up in blood pressure exceeded that in body weight. Greater differences in birth weights between monozygotic twins were associated with smaller differences in systolic blood pressure at 1 year, suggesting that intrauterine environmental factors related to birth weight are important in determining blood pressure in infancy.

摘要

目的

描述婴儿期双胞胎的血压情况。

设计

对双胞胎队列进行前瞻性研究。

地点

佛罗里达州的教学医院。

研究对象

1976年7月至1989年12月间出生的166对存活双胞胎。

主要观察指标

出生时、14天、1、3、6、9和12个月时的血压及体重。

结果

在整个婴儿期,收缩压和舒张压均与体重相关(出生时r分别为0.41,P<0.001和0.42,P<0.001;1岁时r分别为0.23,P<0.001和0.26,P<0.001)。出生体重<1500g的婴儿,从出生到1岁时平均血压从约45/25mmHg升至101/55mmHg,而出生体重>3000g的婴儿则从63/39mmHg升至100/61mmHg;1岁时相应的平均体重分别为7.86kg和9.88kg。同卵双胞胎对中出生体重的差异与1岁时收缩压的差异呈负相关(r=-0.37,P<0.01)。

结论

双胞胎的血压和体重在整个婴儿期呈强正相关但总体相关性下降。出生体重较低的双胞胎在婴儿期血压上升速度更快。1岁时血压的追赶超过了体重。同卵双胞胎出生体重差异越大,1岁时收缩压差异越小,这表明与出生体重相关的宫内环境因素在决定婴儿期血压方面很重要。

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