北京市6~8岁儿童偶测血压偏高现象

  目的  探索6~8岁儿童不同时期偶测血压偏高检出率的差异，为揭示白大衣高血压现象对儿童血压测量真实现况的影响提供参考依据。  方法  基于北京儿童生长与健康队列(PROC)，于2018年10月—2019年6月收集基线身体测量和血压基线及重复3次测量数据，最终纳入1 785名拥有完整数据的儿童进行分析。采用《中国3~17岁儿童性别、年龄别和身高别血压参照标准》对基线、重复测量第1次、重复测量后2次的平均血压偏高检出率进行比较，分析不同时间儿童血压偏高检出率的波动。  结果  6~8岁儿童3次血压偏高的检出率分别为57.65%，25.88%和15.46%，男生基线与重复测量第1次、基线与重复测量后2次、重复测量第1次与重复测量后2次血压偏高检出率均高于女生(58.03%，27.49%，17.08%;57.27%，24.31%，13.87%)，基线血压偏高检出率明显高于重复测量第1次和重复测量后2次的平均血压偏高检出率，且差异有统计学意义(P < 0.01)。基线与重复测量后2次的平均收缩压偏高、舒张压偏高、血压偏高的诊断一致性在3组血压一致性比较中最低。3组血压偏高的一致性比较中，收缩压偏高的一致性相对高于舒张压。  结论  基线血压和重复血压测量的第1次均存在血压波动，重复测量后2次的平均值可能会较好地反映儿童真实血压。

Fluctuation of elevated blood pressure among 6-8 years old children in Beijing

  Objective  To explore differences in the detection rate of elevated blood pressure (BP) in children aged 6-8 years old, and to verify the apparent existence of white-coat hypertension (BP) in children.  Methods  Based on census data(PROC), and three subsequent BP readings were taken during follow-ups which were carried out from October 2018 to June 2019. A total of 1 785 children were included in the present study. Using updating blood pressure reference for Chinese children aged 3-17 years, compared the BP detection rate at baseline, at the first follow-up, and the average value of the last two BP readings. Fluctuations in the detection rate of elevated BP in children at different time-points were analyzed.  Results  The detection rates of the three elevated BP measurements of 6-8-year-old children were 57.65%, 25.88% and 15.46%, respectively, and the detection rate was higher among boys than girls. The detection rate of baseline BP was higher than that of the first follow-up BP measurements and the average of the last two BP measurements(P < 0.01). Given the agreement in the diagnosis of high SBP, high DBP, high BP at baseline, and the average of the last two follow-up BP measurements, elevated BP at baseline was the lowest among the three groups and SBP was higher than DBP.  Conclusion  Blood Pressure fluctuations might be caused by transient tension that was experienced during the baseline BP measurement and during the first of the three follow-ups. Therefore, the average value of last two BP measurements may better reflect the real BP level in children.