首页|儿童青少年血压偏高的4种简化筛查方法效果评价

儿童青少年血压偏高的4种简化筛查方法效果评价

扫码查看
目的 根据中国高血压防治指南(2018年修订版)对儿童青少年血压偏高常用的4种简化筛查方法进行效果评价,为儿童青少年血压异常的早期识别提供参考依据。方法 于2021年10-11月,采用分层整群随机抽样方法对山西省某市5 211名儿童青少年进行体质监测,将中国高血压防治指南作为金标准,分别计算公式法、身高别法、年龄组别表格法和性别年龄别表格法筛查血压偏高的灵敏度、特异度、曲线下面积(AUC)和Kappa值等指标评价筛检效果。结果 金标准、公式法、身高别法、年龄组别表格法和性别年龄别表格法筛查儿童青少年血压偏高率分别为21。9%,24。0%,21。1%,24。5%和20。2%。公式法、性别年龄别表格法与金标准判定结果差异均无统计学意义(x2值分别为1。12,1。41,P值均>0。05),而身高别法和年龄组别表格法与金标准判定结果差异均有统计学意义(x2值分别为20。39,67。09,P值均<0。05)。身高别法AUC最大,为0。94(95%CI=0。93~0。95);年龄组别表格法AUC最小,为0。87(95%CI=0。86~0。88)。身高别法和性别年龄别表格法的Kappa值分别为0。89,0。89,均大于0。85,与金标准的筛查效果更吻合。分性别、年龄和体质量指数(BMI)情况比较时,男生、6~11岁和非超重肥胖组的筛查效果与总体一致,而女生、12~17岁、超重组和肥胖组的筛查效果与总体不同。年龄组别表格法的AUC(0。87)、Kappa值(0。71)和灵敏度(82。33%)均最低,筛查效果最差。结论 身高别法筛查儿童青少年血压异常效果更好,该方法适用于儿童青少年血压异常的早期识别和自我检测。
Performance of four simplified screening methods of elevated blood pressure among children and adolescents
Objective To evaluate the performance of four simplified screening methods of elevated blood pressure commonly used among children and adolescents according to Chinese guidelines for prevention and treatment of hypertension(revised in 2018),so as to provide a reference for the early detection of the elevated blood pressure among children and adolescents.Methods Stratified cluster random sampling method was used to monitor the physical fitness of 5 211 children and adolescents in a city of Shanxi Province from October to November 2021.Chinese guidelines for prevention and treatment of hypertension was considered as gold standard,and sensitivity,specificity,area under the curve(AUC)and Kappa value were calculated to evaluate the screening effectiveness of formula method,height-specific method,age group-specific method,sex and age-specific method for screening ele-vated blood pressure.Results The detection rates of elevated blood pressure among children and adolescents screened by gold standard,formula method,height-specific method,age group-specific method,sex and age-specific method were 21.9%,24.0%,21.1%,24.5%and 20.2%,respectively.There was no significant difference between prevalence of elevated blood pressure screened by formula method,sex and age-specific method and gold standard(x2=1.21,1.41,P>0.05),whereas height-specific method and age group-specific method had significant differences with gold standard(x2=20.39,67.09,P<0.05).AUC was the largest for height-specific method[0.94(95%CI=0.93-0.95)],and the smallest for age group-specific method[0.87(95%CI=0.86-0.88)].The Kappa values of height-specific method(0.89)and sex and age-specific method(0.89)were both greater than 0.85,which were more consistent with the screening effectiveness of gold standard.When comparing by sex,age and body mass in-dex(BMI),the screening effectivenesses were consistent with the overall in boys,6-11 years and normal body weight groups,while the screening effectivenesses were different in girls,12-17 years,overweight and obese groups.The AUC(0.87),Kappa val-ue(0.71)and sensitivity(82.33%)of age group-specific method were the lowest and the screening effectiveness was the worst.Conclusion Height-specific method is more effective and can be used for early identification and self-detection of blood pressure abnormalities among children and adolescents.

Blood pressureReference standardsArea under curveChildAdolescent

李坤坤、田纬、陶梦梦、曹文君

展开 >

山西医科大学公共卫生学院,太原 030000

长治医学院公共卫生与预防医学系

血压 参考标准 曲线下面积 儿童 青少年

山西省卫生健康委科研项目山西省教育科学"十四五"规划项目

2023002GH-220226

2024

中国学校卫生
中华预防医学会

中国学校卫生

CSTPCD北大核心
影响因子:1.423
ISSN:1000-9817
年,卷(期):2024.45(2)
  • 33