中国全科医学 ›› 2019, Vol. 22 ›› Issue (24): 2897-2906.DOI: 10.12114/j.issn.1007-9572.2019.00.339

所属专题: 指南/共识最新文章合集 高血压最新文章合集

• 专题研究 •    下一篇

2017年美国儿科学会《儿童青少年高血压筛查和管理的临床实践指南》解读及对我国全科医师的指导建议

胡文娟,齐建光*   

  1. 100034 北京市,北京大学第一医院儿科
    *通信作者:齐建光,主任医师,副教授;E-mail:qjg2006@126.com
  • 出版日期:2019-08-20 发布日期:2019-08-20

Interpretation of 2017 AAP Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents and Suggestions for General Practitioners in China 

HU Wenjuan,QI Jianguang*   

  1. Department of Paediatrics,Peking University First Hospital,Beijing 100034,China
    *Corresponding author:QI Jianguang,Chief physician,Associate professor;E-mail:qjg2006@126.com
  • Published:2019-08-20 Online:2019-08-20

摘要: 随着不良生活方式及肥胖等在儿童青少年中的流行,儿童青少年高血压患病率逐渐增加,影响着越来越多儿童青少年的身心健康,并且儿童青少年高血压也增加了成年后高血压和代谢综合征的发生风险。2017年,美国儿科学会详细回顾了近年来的相关文献,对2004年《儿童青少年高血压诊断、评估和治疗的第四次报告》进行了更新,基于正常体质量儿童青少年,制定了新的儿童青少年血压数据表格,建议儿童青少年从3岁开始规律测量血压,有高血压高危因素的儿童青少年每次就诊时均应测量血压,其他健康儿童青少年每年需测量一次血压;3岁以下儿童患高血压的风险增加时,每次健康体检时均应测量血压,且制定了简化筛查表,用于识别需进一步评估的儿童青少年,并对异常血压的初步评估和管理策略进行了优化。本文对该指南进行解读,以期为我国儿童青少年高血压的筛查、诊断与管理提供参考。

关键词: 高血压, 儿童, 青少年, 筛查, 指南, 全科医生

Abstract: With the prevalence of adverse lifestyle behaviors and obesity in children and adolescents,the prevalence of hypertension in children and adolescents is increasing gradually,which affects psychosomatic health in more and more children.In addition,hypertension in children and adolesents increases the development risk of hypertension and metabolic syndrome in adults.In 2017,through reviewing relevant literature,the American Academy of Pediatrics developed this practice guideline to update the 2004 Fourth Report on the Diagnosis,Evaluation,and Treatment of High Blood Pressure in Children and Adolescents.In this guideline,new normative blood pressure(BP) tables based on normal-weight children are created,and it is recommended to measure BP beginning at 3 years of age.Some children with risks for developing hypertension should have BP measured at every health encounter,for otherwise healthy children, however, BP need only be measured annually.Children younger than 3 years should have BP measurements taken at every health check-up if they are at increased risk for developing hypertension.A simplified screening table is created for identifying BPs needing further evaluation. Recommendations on the initial evaluation and management of abnormal BPs are streamlined.In this paper,we interpreted the guideline to provide some advice on hypertension screening,diagnosis and management in Chinese children.

Key words: Hypertension, Child, Adolescent, Screening, Guideline, General practitioners