婴儿高血压74例病因构成与临床分析  

Etiological composition and clinical analysis of hypertension in 74 infants

作　　者：凌晨[1] 陈植[1] 张贺佳 雷蕾 袭越 钱素云[2] 华琳[3] 刘小荣[1] Ling Chen;Chen Zhi;Zhang Hejia;Lei Lei;Xi Yue;Qian Suyun;Hua Lin;Liu Xiaorong(Department of Nephrology,Beijing Children's Hospital Affiliated to Capital Medical University,National Center for Children's Health,Beijing 100045,China;Department of Pediatric Intensive Care Unit,Beijing Children's Hospital Affiliated to Capital Medical University,National Center for Children's Health,Beijing 100045,China;School of Biomedical Engineering,Capital Medical University,Beijing 100069,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院肾内科,100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院重症医学科,100045 [3]首都医科大学生物医学工程学院,北京100069

出　　处：《国际儿科学杂志》2025年第2期127-131,共5页International Journal of Pediatrics

基　　金：北京市医管中心培育项目(PX2023045)。

摘　　要：目的分析婴儿高血压的病因构成及临床特点,为婴儿高血压的诊治提供参考。方法采用回顾性病例对照研究,分析首都医科大学附属北京儿童医院自2016年6月1日至2021年9月30日出院诊断含"高血压"的婴儿临床资料,包括临床表现、辅助检查、治疗方案及随访情况。结果符合条件患儿共74例,其中男婴42例(56.8%),女婴32例(43.2%)。67例(90.5%)存在明确继发因素,其中肾脏疾病35例(47.3%),结缔组织病12例(16.2%),血液肿瘤疾病9例(12.2%)。入院初期心脏超声提示54例(73.0%)存在心室壁增厚,其中轻度31例(57.4%),中度11例(20.3%),重度12例(22.2%)。以病因分组后,肾性高血压组蛋白尿、重度高血压及接受多种降压药物治疗患儿比例明显高于非肾性高血压组(χ^(2)=28.493,P<0.001;χ^(2)=17.283,P<0.001;χ^(2)=17.358,P<0.001);单因素及多因素Logistic回归分析均显示肾性因素是导致婴儿重度高血压的危险因素(OR=11.176,95%CI:2.882~43.339,P<0.001;OR=11.669,95%CI:2.921~46.624,P<0.001)。31例患儿具有6个月及以上的随访记录,其中13例(41.9%)患儿依然需要接受降压药物治疗,其中26例(83.9%)未再记录到血压升高。结论婴儿高血压以继发性为主,肾脏疾病占比高且易导致重度高血压,需要多种降压药物控制。急性期积极降压治疗及去除继发因素有助于婴儿高血压控制,对于治疗方案及远期预后仍需要进一步研究。ObjectiveTo analyze the etiological composition and clinical characteristics of infant hypertension,and provide reference for its diagnosis and treatment.MethodsThis is a retrospective case-control study.Retrospective investigation and analysis were conducted on the clinical data of infants discharged from Beijing Children's Hospital Affiliated to Capital Medical University with a diagnosis of"hypertension"from June 1,2016 to September 30,2021,including clinical manifestations,auxiliary examinations,treatment plans,and prognosis.ResultsA total of 74 eligible children were collected,including 42 male infants(56.8%)and 32 female infants(43.2%).A total of 67 cases(90.5%)had clear secondary factors,including 35 cases of kidney disease(47.3%),12 cases of connective tissue disease(16.2%),and 9 cases of hematological tumor disease(12.2%).At the beginning of the disease,cardiac ultrasound showed that 54 cases(73.0%)had ventricular wall thickening,including mild thickening in 31 cases(57.4%),moderate thickening in 11 cases(20.3%),and severe thickening in 12 cases(22.2%).After grouping by etiology,the incidence of proteinuria and severe hypertension in the renal hypertension group,as well as those receiving multiple antihypertensive drugs,was significantly higher than that in the non-renal hypertension group(χ^(2)=28.493,P<0.001;χ^(2)=17.283,P<0.001;χ^(2)=17.358,P<0.001);Renal disease was risk factor for severe hypertension in infants according to univariate and multivariate logistic regression analysis respectively(OR=11.176,95%CI:2.882~43.339,P<0.001;OR=11.669,95%CI:2.921~46.624,P<0.001).Thirty-one children had follow-up records for 6 months or more,and 13(41.9%)still required antihypertensive treatment,of whom 26(83.9%)were no longer recorded as having elevated blood pressure.ConclusionInfant hypertension is mainly secondary,with a high proportion of renal factors and predisposition to severe hypertension,which requires multiple antihypertensive drugs for control.Active antihypertensive treatment and removal of secon

关 键 词：婴儿 高血压 肾性高血压 临床分析 

分 类 号：R725.4[医药卫生—儿科]