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目的探讨秦皇岛市7~12岁学龄儿童上臂围身高比值(AHtR)分布特征及其与血压的关系,为早期识别儿童高血压提供参考。方法通过分层整群随机抽样,抽取秦皇岛市5所小学1 352名7~12岁汉族儿童进行问卷调查及身高、体重、右上臂围、血压等指标测量,并计算AHtR。结果男生7~12岁各年龄组AHtR中位数为0.142~0.154,女生为0.136~0.143。相关性分析显示,AHtR与年龄相关无统计学意义(男生:r=0.020,P=0.607;女生:r=-0.044,P=0.258),与儿童血压呈正相关(rSBP=0.304,rDBP=0.153,P值均<0.01)。AHtR识别儿童高血压的ROC曲线下面积男生为0.765(95%CI=0.692~0.837,P=0.000),女生为0.716(95%CI=0.615~0.817,P=0.000)。男生AHtR切点为0.17,女生为0.15;灵敏性男生为54.3%,女生为69.4%;特异性男生为84.5%,女生为68.1%。结论 AHtR与儿童高血压密切相关,且诊断切点与年龄无关,是儿童高血压筛查的简单有效指标。
Objective To investigate the distribution characteristics of upper limb circumference height ratio (AHtR) and its relation with blood pressure in school-age children aged 7-12 years in Qinhuangdao, and to provide a reference for early identification of children’s hypertension. Methods A total of 1 352 Han children aged 7-12 years from 5 primary schools in Qinhuangdao City were selected for questionnaire survey and height, weight, right arm circumference, blood pressure and other indicators were measured by stratified cluster sampling and AHtR was calculated. Results The median AHtR of boys aged 7-12 years was 0.142 ~ 0.154 and girls 0.136 ~ 0.143. Correlation analysis showed that there was no significant correlation between AHtR and age (boys: r = 0.020, P = 0.607; girls: r = -0.044, P = 0.258) and had a positive correlation with blood pressure (rSBP = 0.304, rDBP = 0.153, P <0.01). The area under the ROC curve of AHtR in identifying children with hypertension was 0.765 (95% CI = 0.692-0.837, P = 0.000) and 0.716 for girls (95% CI 0.615-0.817, P = 0.000). Male AHtR cut point was 0.17, girls 0.15; sensitive boys 54.3%, 69.4% of girls; specific male 84.5%, girls 68.1%. Conclusion AHtR is closely related to hypertension in children, and the diagnosis of cut-off point has nothing to do with age, which is a simple and effective indicator of screening for hypertension in children.