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目的探讨儿童直立性高血压(OHT)的发病情况及临床特征。方法收集2009—2015年在北京大学第一医院儿科住院的以晕厥、头晕等为主要表现的1348例儿童的病例资料,检出OHT患儿24例,分析其人口学特征、各种临床表现的发生率、诱发因素及卧立位血压变化情况。结果 (1)OHT男14例,女10例,男女患病率≤12岁者与>12岁者所占比例差异均无统计学意义;(2)直立性高收缩压(s OHT)与直立性高舒张压(d OHT)≤12岁者与>12岁者所占比例、男女所占比例差异均无统计学意义;(3)就诊时最常见的症状为晕厥、头晕、胸闷等,其中发生晕厥和胸闷症状者以d OHT患儿居多,s OHT与d OHT患儿出现头晕症状者比例相当;多在患儿突然体位变化(41.7%)或持久站立(37.5%)、持久坐位(37.5%)时发生;其中持久站立和持久坐位是诱发s OHT的主要原因,而突然体位变化是d OHT的主要诱因。结论 OHT患儿发病与分型均不存在年龄及性别差异,以晕厥、头晕和胸闷为主要临床症状;持久站立和持久坐位是诱发s OHT的主要原因,而突然体位变化是d OHT的主要诱因。
Objective To investigate the incidence and clinical characteristics of children with orthostatic hypertension (OHT). Methods A total of 1348 cases of children with syncope and dizziness, who were hospitalized in Peking University First Hospital from 2009 to 2015, were collected. The data of 24 children with OHT were detected and their demographic characteristics, clinical manifestations Incidence, predisposing factors and changes in lying position blood pressure. Results (1) There were 14 OHT males and 10 females. There was no significant difference in the proportions of male and female patients ≤12 years old and> 12 years old. (2) The relationship between erected systolic pressure (s OHT) (D OHT) ≤ 12 years of age and> 12 years old, the proportion of men and women were no significant difference; (3) The most common symptoms of treatment were syncope, dizziness, chest tightness, etc. The incidence of dizziness was highest in those with d OHT and those with d OHT and dOHT, respectively. Most of them had sudden changes in position (41.7%) or persistent (37.5%), long-term sitting (37.5% %) Occurred; which long-standing and long-lasting sitting is the main cause of s OHT induced, and sudden changes in position is the main cause of d OHT. Conclusions There is no age and gender difference in the incidence and type of OHT in children with syncope, dizziness and chest tightness as the main clinical symptoms; long standing and long-term sitting is the main cause of s OHT induced, and sudden changes in position is the main cause of d OHT .