电子血压计与水银血压计重复测量血压的研究

目的比较电子血压计与水银血压计重复测量的稳定性,评价吴博士RG-BPⅡ5800型脉搏波电子血压计准确性。方法使用标准台式水银血压计与吴博士RG-BPⅡ5800型电子血压计对270名受试者同臂同步重复连续测量血压5次,比较两种血压计测量的数值的差异以及合适测量次数。结果以水银血压计测量值为参照,电子血压计偏差为0.8 mm Hg/0.2 mm Hg(收缩压/舒张压),电子血压计测量值偏差的标准差为4.5 mm Hg/6.2 mm Hg(收缩压/舒张压)。心力衰竭患者使用电子血压计测量时舒张压值低于水银血压计1.0 mm Hg(P=0.036)。在测量收缩压时,电子血压计测得前三次的数值呈递减趋势,从第三次开始数值趋于稳定,水银血压计测得第一次数值高于后四次测量数值,后四次数值变化趋势不稳定,差异有统计学意义(均为P<0.05)。在测量舒张压时,电子血压计第一次数值高于后四次测量数值,水银血压计五次测量值之间差异无统计学意义(均为P<0.05)。结论吴博士RG-BPⅡ5800型脉搏波电子血压计测量血压具有较好的准确性,在临床应用中可代替水银汞柱血压计使用,心力衰竭的患者使用脉搏波电子血压计测量血压时收缩压读数相差1 mm Hg以内,电子血压计重复测量收缩压稳定性较水银血压计好。     

电子血压计测量血压的重复性研究

目的:在一般人群中评价电子血压计测量血压的重复性.方法:选择492例研究对象,所有研究对象在标准状态下采用电子血压计测量血压3次,取3次测量值均数作为平均血压水平,采用重复测量资料的方差检验分析3次测量值之间差异有无统计学意义,同时根据年龄和脉压分层分析可能影响电子血压计测量血压重复性的影响因素.结果:收缩压、舒张压、平均动脉压和脉压的3次测量值间两两比较差异均有统计学意义,第1次测量值最高,第2次和第3次测量值依次降低.根据年龄分组后,在不同年龄组中的3次测量值仍是第1次最高,第2次和第3次测量值依次降低,差异有统计学意义.根据脉压分组后,在脉压<35 mmHg组,收缩压、舒张压、平均动脉压和脉压在3次测量间差异均无统计学意义.在脉压≥35 mmHg(1 mmHg=0.133 kPa)组,无论收缩压、舒张压还是平均动脉压,3次测量值间两两比较差异均有统计学意义,测量值随着测量次数逐渐降低.结论:电子血压计3次测量间两两比较的差异均有统计学意义,而脉压可能是影响电子血压计测量血压重复性的因素之一.     

电子血压计与汞柱血压计测量结果对比观察

<正>血压测量是临床工作中一项重要的操作,可以协助诊断疾病以及评价用药效果。近年来,电子血压计广泛应用于临床,其性能不断提升。本院在临床上发现袖带式电子血压计对年龄较大或是臂围较细的患者进行血压测量时,其测量结果较汞柱血压计的测量值有不同程度的差异。本文通过对比两种血压计的测量结果以观察电子血压计在血压测量中的准确性。1资料与方法1.1一般资料:选取2014年3月至5月我院住院患     

宽袖带与常规宽度袖带臂式电子血压计测量血压结果的对比分析

目的 探索宽袖带(宽度为18 cm)与常规宽度袖带(宽度为13 cm)臂式电子血压计在测量血压值的差异.方法 选择2018年5-11月于河北医科大学第二医院心内科住院患者1 155例,其中男性占47％,年龄(59.7±13.2)岁.根据臂围大小将患者分为4组:第1组臂围范围为15～21 cm,第2组为22～26 cm,...     

常用家庭电子血压计示值重复性和准确度的研究

目的:对常用家庭电子血压计示值重复性和准确度进行再评估.方法:选择中国人民解放军空军特色医学中心高血压和心内科门诊患者140例,以水银血压计测量3次的血压平均值为真实血压水平,依据《JJG692-2010无创自动测量血压计检定规程》和听诊法对患者使用的140台家庭电子血压计进行示值重复性和准确度再评估.结果:140台家...     

家庭自测血压可靠性研究

目的探讨电子血压计与台式血压计测量结果有无差异,探讨电子血压计使用的临床意义。方法随机抽取2008年3月至4月山西太原中辐医院内科住院高血压患者作为对象,采取同一患者休息10min后卧位同侧肱动脉分别用电子血压计和台式血压计随机先后测量血压,共164例,再进行比较和统计。结果电子血压计和台式血压计测得血压有统计学差异。结论电子血压计测得血压值偏高于台式血压计测得血压值,但电子血压计因其快捷、方便,仍是家庭自测血压的较好选择,是台式血压计作为诊断和治疗依据的补充,是血压监测的主要手段。     

电子血压计与汞柱血压计测量结果比较

目的测试电子血压计测量的准确性，寻求电子血压计最有效的测量模式。方法采用分层随机抽样法抽得门诊及住院病人共1500人，固定专人分别用电子血压计固定模式测量法、非固定模式测量法与汞柱血压计测量右上肢肱动脉的血压。结果用电子血压计固定模式测量法与汞柱血压计所测上肢的血压值差异无统计学意义；而电子血压计非固定模式测量法与汞柱血压计所测上肢的血压值差异有统计学意义，血压绝对值收缩压相差（7．5±1．06）mmHg，舒张压相差（9．4±1．06）mmHg。结论电子血压计测量的血压数值是准确的，可代替汞柱血压计测量血压。但由于电子血压计敏感度高，运用固定的测量模式才能确保血压数值的准确性。     

对腕式电子血压计的准确性评价

目的评价欧姆龙HEM-6001型电子血压计的准确性并分析影响准确性的因素。方法151名试验对象,年龄范围19~78岁,平均年龄50±16岁。臂围20~40cm,腕围12.5~23cm。静息收缩压(SBP)范围85~192mmHg,舒张压(DBP)范围52~118mmHg,其中男性81名,女性70名。按水银柱式血压计、欧姆龙HEM-7000、水银柱式血压计、欧姆龙HEM-6001、水银柱式血压计的顺序测定同一侧上臂的血压。结果欧姆龙HEM-6001、HEM-7000型电子血压计均与水银柱式血压计所测血压值相关性较好,用BHS标准评估分别达到C/B级和B/A级。两者与听诊法测量的血压(SBP/DBP)差值分别为:0.59±8.92/0.43±7.34mmHg(HEM-6001)和-0.79±7.65/1.27±6.05mmHg(HEM-7000)。HEM-6001型的测量差值与臂围大小呈正相关(RSBP=0.315,P<0.01;RDBP=0.245,P<0.01),与腕围大小也呈正相关(RSBP=0.237,P<0.01;RDBP=0.183,P<0.05);HEM-7000型的测量差值与臂围大小不相关(RSBP=-0.066,P>0.05;RDBP=-0.022,P>0.05),与腕围大小也不相关(RSBP=0.098,P>0.05;RDBP=0.033,P>0.05)。结论臂围与腕围特别粗或细的人在使用腕式电子血压计时要注意到臂围和腕围对测量结果的影响。     

Hypertension in children and adolescents

Pediatric hypertension (HTN) has become the focus of interest recently due to its increasing prevalence. This is mainly related to the increase in childhood obesity, although the current evidence suggests that other lifestyle factors, apart from obesity, contribute to high blood pressure (BP) in childhood. Traditionally, office BP measurements by the physician have been the cornerstone for the assessment of HTN in children. However, since the white coat and masked HTN phenomena are not rare in childhood, out-of-office BP measurements have significantly improved the accurate diagnosis of HTN and decision making. Ambulatory BP monitoring is regarded as indispensable for the evaluation of pediatric HTN, providing details not only for the staging for HTN, but also for the study of other ambulatory BP patterns. It should be pointed out that HTN in children and adolescents is associated with target-organ damage which is significant in terms of cardiovascular risk. The current knowledge, outlined in the present review, is expected to help in early and accurate diagnosis as well as in the management of HTN in children and adolescents.     

贵州省少年儿童氟骨症流行因素调查

应用环境流行病学方法调查了少儿氟骨症转换突出的金沙县联合村患者及病区对照共６２人的人群及环境因素，发现有摄氟量（人平均５５．４４±２５．６６ｍｇ／ｄ）营养低下、钙摄入不足（达标率７９．８２％）及氟铝联合作用的特点。     

Effect of the introduction of dietary sucrose on metabolic control in children and adolescents with type I diabetes

The effect of sucrose in the diet of children and adolescents with type I diabetes on long-term metabolic control was studied. For a mean observation period of 83 (range 42–127) days, a diet containing 5% of total calories as refined sugar was recommended to 11 children (group A, mean age 15.0, SD 5.4 years), while another 13 children remained on their usual sucrose-free diet (group B, mean age 16.0, SD 5.7 years). The mean observation period in this group was 77 (41–103) days. All children had a dietary assessment at baseline and at follow up using a 7-day food record. At baseline, sucrose intake as a proportion of total daily calories was similar in the two groups (group A 1.4, SD 1.9% vs group B 2.0, SD 2.3%;P=0.5). At follow-up, sucrose intake increased significantly in group A (5.1, SD 2.5%;P=0.0008), but not in group B (2.7, SD 3.3%;P=0.5). Metabolic control assessed by haemoglobin level (HbA_1c) was not different between the groups at baseline (group A 8.5, SD 1.2 vs group B 8.8, SD 1.8%;P=0.7) nor at follow-up (9.1, SD 1.4 vs 9.0, SD 2.5%;P=0.9). Within group A, the individual change in HbA_1c correlated with the individual change in sucrose intake (r=0.61,P=0.05), this correlation being strongly influenced by two individuals with an increase in sucrose consumption substantially exceeding 5%. Percentage intake of protein, carbohydrate and fat did not change significantly. Fibre consumption decreased with increasing consumption of sucrose in group A (r=–0.75,P=0.007). It is concluded that the introduction of sucrose in the diet of children and adolescents with type I diabetes up to 5% of the daily total calories has no negative effect on metabolic control but reduces the amount of fibre in the diet. Higher amounts of sucrose might have negative effects on metabolic control.     

Low vitamin D status is associated with obesity but no other cardiovascular risk factors in Chinese children and adolescents

Background and aimsEvidence on relationship between vitamin D status and cardiovascular health in childhood remains inconsistent. This study aimed to investigate vitamin D status and its relationship with cardiovascular risk factors in Chinese children and adolescents.Methods and resultsCross-sectional data were obtained from 2680 children and adolescents aged 7-18 y in Guangzhou, South China. Anthropometric and socioeconomic characters, concentration of serum 25-hydroxyvitamin D [25(OH)D], fasting blood glucose and lipids, as well as information about diet and physical activity were measured and collected. Logistic regression model was adopted to analyze the associations between 25(OH)D levels and cardiovascular risk factors including obesity, high blood pressure, dyslipidemia, hyperglycemia, and metabolic syndrome. Overall, median level of 25(OH)D was 19.74 ng/mL. The prevalence rates of vitamin D deficiency and inadequacy were 7.5% and 44.4%, both of which were highest among adolescents aged 14-18 y (14.5% and 51.6%, respectively). As vitamin D level increased, an upward trend in fasting glucose concentrations was observed in subjects with normal fasting glucose level, but not in subjects with hyperglycemia. Among the assessed cardiovascular risk factors, vitamin D status was only inversely associated with general obesity, and the adjusted odds ratio was 1.95 (95% CI: 1.08–3.49), comparing the lowest 25(OH)D quartile with the highest one.ConclusionsVitamin D deficiency and inadequacy remain a concern among school-aged children and adolescents in Guangzhou, South China, particularly in adolescents aged 14-18 y. However, low vitamin D status was found only associated with general obesity but no other cardiovascular risk factors.     

Accuracy of multi-echo Dixon sequence in quantification of hepatic steatosis in Chinese children and adolescents

BACKGROUND Nonalcoholic fatty liver disease(NAFLD) is currently the outstanding cause of chronic liver disease in children and adolescents, especially in overweight and obese groups. Liver biopsy is the reference standard to diagnose NAFLD but invasive, thus it is not the best choice in clinical diagnosis and follow-up.Magnetic resonance(MR) is widely used in clinical trials to noninvasively quantify liver fat content in adults and children in foreign countries. While currently, it is rarely used in Chinese children and adolescents. We postulated that quantifying hepatic steatosis by MR could be extended to children and adolescents in China.AIM To investigate the accuracy of MR imaging(MRI) in quantifying liver fat with MR spectroscopy(MRS) as a reference. A secondary goal was to assess the prevalence of NAFLD in overweight and obese Chinese children and adolescents.METHODSThere were 86 children and adolescents enrolled in this study, including 65 overweight and obese children and 21 healthy children. The participants underwent MRI and MRS. MRI and MRS were performed using multi-echo Dixon and HISTO sequences, respectively, to calculate hepatic proton density fat fraction(PDFF). Hepatic steatosis was diagnosed using MRS-PDFF > 5% as the threshold. Spearman's analysis was used to evaluate the correlation between MRI and MRS. The agreement between these two methods was assessed by BlandAltman analysis.RESULTS The MRI-PDFF in the MRS region of interest and the entire liver was 9.9% ±10.3% with a range of 0.3%-39.9%, and 10.6% ± 9.4% with a range of 1.9%-38.9%,respectively. The MRS-PDFF was 9.1% ± 10.0%, with a range of 0.5%-37.8%. The incidence of hepatic steatosis detected by MRS-PDFF was 46.5%(40/86) of all participants, all of whom belonged to the overweight and obese group.Spearman's analysis indicated an excellent correlation between multi-echo Dixon and MRS(r > 0.9, P < 0.01). Bland-Altman analysis also demonstrated a good agreement between these two methods.CONCLUSION Multi-echo Dixon shows an excellent correlation and agreement with MRS in quantifying liver fat content and could be a potential tool to detect hepatic steatosis in Chinese children and adolescents.     

血压偏高儿童青少年进行血糖筛查的重要性

目的对10～18岁儿童青少年进行T2DM筛查并评价美国糖尿病协会（ADA）推荐的儿童青少年T2DM筛查方案。方法采取分层整群随机抽样的方法,在北京市昌平区自然人群中抽取10～18岁在校中小学生3719人,对符合下列条件之一者进行血糖筛查：（1）超重/肥胖：BMI〉同年龄、性别第85百分位数者;（2）血压偏高：血压≥同年龄、性别第90百分位数者。对FPG≥5.6mmol/L者行OGTT进行诊断,并按2008年ADA推荐的筛查方案进行评价。结果T2DM确诊率0.98/1000,IFG确诊率30.3/1000。IFG患者中超重/肥胖伴血压偏高者占51.6%,单纯超重/肥胖者占6.5%,单纯血压偏高者占41.9%。如按ADA建议不筛查单纯血压偏高者,将有近半数IFG患者漏诊。结论单纯血压偏高儿童青少年进行糖代谢检查十分必要。     

DXA-measured visceral fat mass and lean body mass reflect abnormal metabolic phenotypes among some obese and nonobese Chinese children and adolescents

Background and aim

The exact constellation of body composition characteristics among metabolically unhealthy obese (MUO) and nonobese (MUNO) children and adolescents remains unclear. The purpose of this study was to identify the major body composition determinants of metabolically unhealthy phenotypes among Chinese children and adolescents.

放射性核素电子计算机断层摄影测量左室心肌质量与儿童青少年血压关系的研究

高血压合并左心室肥厚早已被人熟知。近年来研究发现左室心肌质量的增加伴随着血压明显增高达９０百分位或以上在儿童时期即已出现。一般认为左室心肌质量的增加是高血压或血压偏高的结果。仅在最近几年才有少数作者发现左室心肌质量的增加出现在儿童发生血压增高之前。血压正常儿童或青少年之父母有高血压者，其左室心肌质量均高于无高血压家族史者。本研究者在观察血压增高与高血压家族史及左室心肌质量之间的关系时，结果发现在高血压高危儿童并有家族史者左室心肌质量高于高血压高危儿童无高血压家族史者，提示除血压增高可能为左室心肌质量增加之原因外，而且左室心肌质量之增加尚可能为高血压之原因，即有可能在先天因素中存在左室心肌质量易于增加的因子或者说不能除外心室肌异常基因的存在。     

儿童及青少年血压踏车运动负荷试验的临床意义

对我们在１９８７年进行的踏车血压运动负荷试验的２３６名６～１９岁健康儿童及青少年分别于１９９２年、１９９４年随访血压及踏车运动试验，并采用１９８７年拟定的运动试验阳性标准，对安静收缩血压９０以上百分位（Ｐ）与运动试验阳性者进行横向及纵向分析。得出以下结论：１．１９８７年血压４５～５５Ｐ及≥９０Ｐ组，运动试验阳性率分别为１１．８％及４３．５％；２．三个年度血压均≥９０Ｐ组，两次≥９０Ｐ组及一次≥９０Ｐ组，三次运动试验均阳性的百分比分别为５４．２％，８．２％及２．４％；３．１９８７年血压≥９０Ｐ者按运动试验阳性、阴性分组分析１９９２、１９９４年血压资料，阳性组血压仍保持≥９０Ｐ者为６５．５％、４７．３％，阴性者为２９．２％及２０．３％；４．１９８７年血压≥９０Ｐ者运动试验阳性组中１９９２、１９９４年两年血压均≥９０Ｐ者明显高于阴性组，分别为３４．５％及７．２％；（以上均经统计学处理Ｐ＜０．００１或Ｐ＜０．００５）说明本课题拟定的血压运动负荷试验标准有明确的临床价值。     

儿童青少年代谢综合征心率减速力变化与糖脂代谢异常关系的研究

目的探讨儿童青少年MS心率减速力(DC)变化与血糖、血脂代谢异常的关系。方法选取2015年1月至2016年5月于南阳市中心医院内分泌科确诊为MS的100例10~16岁儿童青少年(MS组);同期于我院体检健康的100名儿童青少年为正常对照(NC)组。检测两组DC、血糖及血脂指标变化,随访心血管事件的发生率及其影响因素。结果两组WC、BMI、FPG、2 hPG、HbA1c、HDL-C、LDL-C、TG、DC比较,差异有统计学意义(P<0.05或P<0.01)。MS组治疗前后WC、BMI、FPG、2 hPG、HbA1c、HDL-C、LDL-C、DC比较,差异有统计学意义(P<0.05)。与低危亚组比较,中、高危亚组超重/肥胖、血糖、血脂异常发生率差异有统计学意义(P<0.01)。Pearson相关性分析显示,DC与HDL-C呈正相关(r=0.494,P<0.05),与TG、FPG、WC、HbA1c呈负相关(r=-0.497、-0.496、-0.474、-0.501,P<0.05或P<0.01)。多因素Cox回归分析显示,2 hPG、HbA1c、LDL-C、TG是儿童青少年MS发生不良心血管事件的危险因素,DC是预后的保护因素。结论 DC检测对儿童青少年MS的危险分层及心血管事件有一定预测价值。