目的 基于2017年美国儿科协会(American Academy of Pediatrics，AAP)的《儿童青少年高血压筛查和管理临床实践指南》(美国AAP标准)、国际儿童青少年血压偏高百分位参考值(国际标准)、中华人民共和国卫生行业标准《7岁～18岁儿童青少年血压偏高筛查界值(WS/T 610-2018)》(行业标准)以及《中国高血压防治指南(2018年修订版)》(指南标准)，描述及分析2016-2017年中国7～17岁儿童青少年各年龄组正常高值血压和血压偏高检出率，并对4种判定标准进行一致性检验。方法 数据来源于2016-2017年中国儿童与乳母营养健康监测，该调查采用多阶段分层整群抽样方法，从31个省(自治区、直辖市)的275个监测点中抽取调查对象，经数据清理共纳入7～17岁研究对象67 231名。血压测量采用电子血压计在同一时点重复测量3次的血压均数分别作为研究对象的收缩压及舒张压。为与抽样设计方法相匹配，采用国家统计局提供的第六次人口普查数据对结果进行加权调整，考虑各层抽样权重。结果 中国7～17岁儿童青少年正常高值血压检出率由高到低依次为美国AAP标准(20。15％)＞指南标准(17。29％)＞行业标准(13。14％)＞国际标准(12。66％)，血压偏高检出率由高到低依次为指南标准(24。31％)＞国际标准(21。34％)＞美国AAP标准(20。59％)＞行业标准(19。96％)。检出率随年龄的升高而下降。结论 尽管美国AAP标准和国际标准与我国两项标准的一致性均为中高度一致，但检出率差异较大，考虑到种族差异，在应用国外标准判断我国儿童青少年血压情况时应持谨慎态度。
Status of elevated blood pressure among Chinese children and adolescents aged 7-17 from 2016 to 2017 according to 4 different references
OBJECTIVE To describe and analysis the detection rate of high normal blood pressure and high blood pressure among Chinese children and adolescents aged 7-17 years from 2016 to 2017 according to the clinical practice guideline for screening and management of high blood pressure in Children and Adolescents published by the American Academy of Pediatrics(the AAP reference),the international blood pressure references among Children and Adolescents aged 6 to 17 years(the international reference),health industry standard of the People's Republic of China"Reference of screening for elevated blood pressure among children and adolescents aged 7 to 18 years(WS/T 610-2018)"(the industry reference)and updating blood pressure references for Chinese children aged 3 to 17 years(the guideline reference).METHODS Data was from the China Nutrition and Health Surveillance of Children and Lactating Women(2016-2017),in which the multistage stratified whole group random sampling method was used to draw participants from 275 surveillance sites in 31 provinces(autonomous regions and municipalities).In total,67 231 participants were included according to the inclusion and exclusion criteria.Blood pressure was measured three times by trained staff using a validated oscillometric blood pressure monitor at the same point.The average blood pressure was calculated for the three measurements for SBP and DBP.To match the sampling design methodology,all values were weighted to represent the total population of Chinese children and adolescents 7-17 years of age considering sampling weights for each stratification based on the sixth population census data provided by the National Bureau of Statistics.RESULTS The detection rate varied greatly under different references.The detection rate of high normal blood pressure was ranked from high to low according to the AAP reference(20.15％)＞the guideline reference(17.29％)＞the industry reference(13.14％)＞the international reference(12.66％);the detection rate of high blood pressure in descending order is the guideline reference(24.31％)＞the international reference(21.34％)＞the AAP reference(20.59％)＞the industry reference(19.96％).CONCLUSION Although the consistency between the AAP references and international references and our national two references were medium to high,the difference in detection rate obtained by analysis was large.Considering the differences of demographic characteristics in the reference population,caution should be taken when applying foreign references to judge the blood pressure status of children and adolescents in China.
blood pressurechildren and adolescentsnutrition and health surveillance
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万方数据
