摘要
目的：回顾性分析直立性高血压（orthostatic hypertension,OHT）儿童24 h 动态血压监测（ambulatory blood pressure monitoring,ABPM）特征及其健康教育效果。方法选择2010年12月至2013年9月在中南大学湘雅二医院儿童晕厥专科门诊就诊或住院的以不明原因晕厥及先兆晕厥为主诉儿童,经直立倾斜试验（head up tilt test,HUTT）确诊为 OHT 儿童19例,男11例,女8例,年龄（11.26±2.16）岁。经健康教育（包括心理指导、避免突然改变体位姿势、增加饮水量、避免晕厥诱因等）12～190（47±48）d 后复查 HUTT 及 ABPM。结果（1）ABPM 参数：健康教育前后 ABPM 参数（全天平均收缩压、全天平均舒张压、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压、收缩压昼夜差值、舒张压昼夜差值）差异未见统计学意义（P 均﹥0.05）。（2）HUTT 3 min内血压变化：健康教育后较健康教育前 HUTT 3 min 内舒张压[（71.89±1.60）mmHg vs.（76.47±8.49）mmHg,1 mmHg ＝0.133 kPa,t ＝2.785,P ﹤0.05]和舒张压改变[（7.37±4.98）mmHg vs.（12.42±3.27）mmHg, t ＝3.560,P ﹤0.05]降低。（3）血压类型变化：健康教育后“勺型血压”稍增加,“非勺型血压”稍减少,但差异无统计学意义[分别为42.1%（8/19）vs.31.6%（6/19）和57.9%（11/19）vs.68.4%（13/19）,χ2＝0.452,P ﹥0.05]。（4）OHT 治愈率：健康教育后复查 HUTT,19例 OHT 儿童 HUTT 3 min 内血压变化在正常范围14例,治愈率73.7%。结论 OHT 儿童血压类型以“非勺型血压”为主,健康教育后“勺型血压”比例增加,HUTT 3 min 内舒张压和舒张压改变降低,表明健康教育对 OHT 儿童具有一定的临床效果。
Objective To analyse the 24 h ambulatory blood pressure monitoring（ABPM）character-istics and effect of health education in children with orthostatic hypertension （OHT）retrospectively.Methods A total of 19 children[1 1 males and 8 females with mean age of （1 1.26 ±2.16）years]who were outpa-tients or had been hospitalized in the Second Xiangya Hospital of Central South University due to unexplained syncope,presyncope,and finally diagnosed as OHT after head up tilt test（HUTT）.HUTT and ABPM were reexamined at 12 ~190（47 ±48 ）days after receiving health education （including psychological guidance, avoiding sudden changes in posture,increasing the amount of water,avoiding syncope inducement,etc）. Results （1 ）ABPM parameters：there were no significant differences of ABPM parameters before and after health education respectively（P ﹥0.05,respectively）.（2）After the health education,HUTT 3 min diastolic pressure[（71.89 ±1.60）mmHg vs.（76.47 ±8.49）mmHg,1 mmHg =0.133 kPa,t =2.785,P ﹤0.05]and diastolic blood pressure change[（7.37 ±4.98）mmHg vs.（12.42 ±3.27）mmHg,t =3.560,P ﹤0.05]de-creased than those before health education.（3 ）Blood pressure pattern changes：after the health education,“dipper blood pressure”increased and “non-dipper blood pressure”decreased[42.1 %（8 /19）vs.31.6%（6 /19）and 57.9%（1 1 /19）vs.68.4%（13 /19）,χ2 =0.452,P ﹥0.05,respectively].（4）OHT cure rate：after health education,to review the HUTT,within 3 minutes in HUTT,blood pressure changes of 14 cases were normal range.The cure rate was 73.7%.Conclusion OHT children＆#39;s blood type is given priority to＆amp;nbsp;with “non-dipper blood pressure”,and the ratio of“dipper blood pressure”increase and the HUTT 3 min di-astolic pressure and diastolic blood pressure change decrease after health education.It suggests that the health education of OHT children has a certain clinical effect.
出处
《中国小儿急救医学》
CAS
2015年第6期387-390,共4页
Chinese Pediatric Emergency Medicine
基金
“十二五”国家科技支撑计划（2012BAl03803）,湖南省卫生厅课题（B2013-013）
关键词
动态血压监测
直立性高血压
儿童
健康教育
治疗效果
Ambulatory blood pressure monitoring
Orthostatic hypertension
Children
Health edu-cation
Treatment effect
