王硕,安雅丽,王金平,姜亚云,邢燕,王巨,向钱,徐媛媛,田文静,刘盛元,邢晓燕,黎明,刘雪莉,张景玲,肖建忠,胡英华,彭崇,李光伟,王滨有.大庆市学龄儿童血压分布、影响因素及其变化趋势研究[J].Chinese journal of Epidemiology,2007,28(11):1055-1059
大庆市学龄儿童血压分布、影响因素及其变化趋势研究
Study On the distribution and risk I'actOrs of hypertension among children： a cohort study
目的了解大庆市学龄儿童血压水平的特点和变化趋势并探讨影响儿童血压水平的危险因素。方法以大庆市小学新人学儿童为研究对象，进行为期五年的前瞻性研究；研究对象每年进行身高、体重和血压的测量，隔年进行三酰甘油、血糖和胰岛素的测定。统计分析采用SPSS 10.0软件。结果447例研究对象中，基线调查高血压患病率为2.01％、血压偏高者15.44％，至第五年患病率增至5。37％、血压偏高者19.46％。5年间，收缩压由(100.65±11.62)mm Hg(1 mm Hg=0.133 kPa)增至(106.67±9.29)mm Hg，舒张压由(66.27±11.31)mm Hg增至(70.28±7.98)mm Hg，第五年男、女生差异显著。高血压家族史、体重指数(BMI)、三酰甘油、胰岛素、胰岛素抵抗指数和胰岛素敏感指数与血压水平有关联；其中家族史、BMI和胰岛素敏感指数对血压的变异解释最有意义，家族史与收缩压和胰岛素的差异与肥胖有关，胰岛素敏感性降低有独立作用。结论大庆市学龄期儿童高血压的患病率高于全国平均水平，肥胖、遗传和胰岛素抵抗是高血压发生的主要危险因素，这三者可独立作用，亦可相互协同。
English Abstract:
objective To expl。re the association between hypertension and the tendency of changeamong children，so as to lay a foundation for the prevention and control of hypertension.IⅥethods Basedon findings from the prevalence survey that carried。ut in September 1 999 in Daqing of Heilon, iangprovince.New admission children were selected as subiects Lo conduct a five-year cohort study.A1l thesub{ects were interviewed with questionnaires and their blOOd specimens were coUected for biochemicalanalysis.All data were analyzed using SPSS 10.O software.results The prevalence of hypertension among447 children was found 2.01％at the baseline study but increased to 5.37％in the fifth year.Du“ng a fiveyear period，the systolic pressure level among children increased frOm (1 00.65± 1 1.62)mm Hg(1 mm Hg二0.133 kPa)to(106.67±9.29)mm Hg，while the diastolic pressure level was from(66.27±11.31)mm Hg to(70.28±7.98)mm Hg and sh。wed significant difference between boys and girls.Therewere association between hypertension and family history，body mass index(BIⅥI)，tri91yceride，insulin，insulin resistance index while insulin sensitivity index and family history，BⅣII and insulin sensitivitv indexappeared to be the important factors.Children under this sLudy were divided to ‘with family history orwithout’and then every group was divided to‘with over weight-obesity or normal’.0besity and insulinsensitivitv seemed the key risk factors on hypertension. Descent of insulin sensitivity was an independentrisk factor. conclusion The level of bl∞d tension among children in Daqing city was higher than thatfrom the national data.The present studv confirmed that over.weight，obesitv，heredity and insulin resistancewere the risk factors of hvpertension while insuhn resistance was rclated to hvpertension.The interaction ofthese risk factors was indeDendent or correlated to each other.