中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (23): 3728-3735.doi: 10.12307/2023.532

• 组织工程相关大数据分析 Big data analysis in tissue engineering • 上一篇    下一篇

海南省6-18岁在校学生高血压现患率及其影响因素分析

王巍潼1，欧阳范献2，李  军3，李佳琪3   

  1. 1海南医学院公共卫生与全健康国际学院，海南省海口市  571199；2海南医学院第二附属医院医院感染管理和疾病预防控制科，海南省海口市570311；3海南省中小学卫生保健所，海南省海口市  570000
  • 收稿日期:2022-08-10 接受日期:2022-08-30 出版日期:2023-08-18 发布日期:2023-01-16
  • 通讯作者: 欧阳范献，博士，主任技师，海南医学院第二附属医院医院感染管理和疾病预防控制科，海南省海口市 570311
  • 作者简介:王巍潼，女，1995年生，辽宁省海城市人，汉族，海南医学院在读硕士。
  • 基金资助:
    海南省社会发展科技专项(SF201313)，项目负责人：欧阳范献；海南省应用技术研究与开发专项(ZDXM2014063)，
    项目负责人：欧阳范献

Prevalence and influencing factors of hypertension in school students aged 6-18 years in Hainan Province

Wang Weitong1, Ouyang Fanxian2, Li Jun3, Li Jiaqi3   

  1. 1International School of Public Health and Whole Health, Hainan Medical University, Haikou 571199, Hainan Province, China; 2Department of Nosocomial Infection Management and Disease Control, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China; 3Hainan Institute of Health Care for Primary and Secondary School Students, Haikou 570000, Hainan Province, China
  • Received:2022-08-10 Accepted:2022-08-30 Online:2023-08-18 Published:2023-01-16
  • Contact: Ouyang Fanxian, MD, Chief technician, Department of Nosocomial Infection Management and Disease Control, The Second Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
  • About author:Wang Weitong, Master candidate, International School of Public Health and Whole Health, Hainan Medical University, Haikou 571199, Hainan Province, China
  • Supported by:
    Social Development Science and Technology Project of Hainan Province, No. SF201313 (to OFX); Applied Technology Research and Development Special Project of Hainan Province, No. ZDXM2014063 (to OFX)

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摘要：

文题释义：

高血压：是一种心血管病综合征，血压只是一个需干预的趋势指标，以临界值定义是不是高血压显得有些武断，这也得到了国内外专家学者的认同。然而，考虑到实际可操作性，只能以血压临界值作为简化诊断和治疗决策的依据。《中国高血压防治指南(2018年修订版)》高血压定义：在未使用降压药物的情况下，患者收缩压≥ 140 mmHg和(或)舒张压≥ 90 mmHg(1 mmHg=0.133 kPa)。
儿童青少年高血压：儿童青少年(指18岁以下人群，简称“儿童”)时期发生的高血压，以原发性高血压为主，多数表现为血压水平的轻度升高(1级高血压)，通常没有不适感，无明显临床症状。除非定期体检时测量血压，否则不易被发现。

背景：儿童青少年高血压近年来检出率增高，是值得关注的公共卫生问题。目前，没有针对海南省全省儿童青少年高血压流行现状和影响因素的探索。儿童青少年高血压早期无明显临床症状，不易被发现。
目的：了解海南省6-18岁在校学生高血压流行现状、分布特征及其影响因素，为早期精准预防及干预提供理论依据。
方法：收集2013-2020年海南省18个市县在校学生健康监测数据，共纳入6 253 567条信息，其中男生3 408 734(54.51%)条信息，女生2 844 833(45.49%)条信息。分别采用《中国3-17岁儿童性别、年龄别和身高别血压参照标准》《中国高血压防治指南2018年修订版》《学龄儿童青少年超重与肥胖筛查界值WS_T586-2018》《7岁-18岁儿童青少年高腰围筛查界值WS_T611-2018》《儿童青少年发育水平的综合评价》标准评估6-17岁儿童青少年血压、18岁青少年血压、体质量指数、腰围和肺活量指数，是否为腹型肥胖采用国际推荐标准判定，即腰围身高比(WHtR)≥0.5为腹型肥胖。采用Spearman相关分析和多分类Logistic回归模型分析体质量指数、腰围、腰围身高比、肺活量指数与血压之间的相关性和危险因素。

结果与结论：海南省6-18岁在校学生高血压分布情况存在如下特征：①儿童青少年高血压分布存在地区聚集性，血压严重程度由高到低依次为南部、东部、西部、中部、北部。②各年龄段男女生各级高血压分布有显著性差异(各组P < 0.001)；男生13岁后正常高值血压检出率涨幅明显大于女生，男生14-17岁后1级高血压检出率稳步上升；6-13岁女生组的血压严重程度高于男生，而14-17岁男生组的血压严重程度高于女生。③多因素Logistic回归分析显示，女生(OR=1.185，95%CI：1.180-1.189，P < 0.001)；体质量指数(超重：OR=1.144，95%CI：1.135-1.154，P < 0.001；肥胖：OR=1.120，95%CI：1.105-1.135，P < 0.001)、腰围(正常腰围高值：OR=1.053，95%CI：1.046-1.061，P < 0.001；高腰围：OR=1.025，95%CI：1.012-1.037，P < 0.001)、腰围身高比(腹型肥胖：OR=1.286，95%CI：1.270-1.303，P < 0.001)为儿童青少年高血压危险因素。年龄、肺活量指数(中等水平：OR=0.956，95%CI：0.944-0.968，P < 0.001；中上等水平：OR=0.869，95%CI：0.858-0.880，P < 0.001；上等水平：OR=0.739，95%CI：0.726-0.753，P < 0.001)为儿童青少年高血压保护因素，肺活量指数水平越高发生儿童青少年高血压的风险越小。④上述数据证实，海南省6-18岁在校学生高血压检出率偏高，地区、检测年份、年龄、性别、体质量指数、腰围、腹型肥胖和肺活量指数均是儿童青少年高血压检出率的影响因素；海南省6-18岁儿童青少年需将体质量指数、腰围、腰围身高比控制在正常范围内，而提高肺活量指数水平是有效控制血压偏高的重要手段。

https://orcid.org/0000-0002-1529-5935(王巍潼)；https://orcid.org/0000-0003-3652-2591(欧阳范献)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 海南省, 儿童青少年, 高血压, 检出率, 影响因素, 体质量指数, 腰围, 腰围身高比, 肺活量指数

Abstract: BACKGROUND: The detection rate of hypertension in children and adolescents has increased in recent years, which is a public health problem worthy of attention. At present, there is no research on the prevalence and influencing factors of hypertension among children and adolescents in Hainan Province. Early hypertension in children and adolescents has no obvious clinical symptoms and is not easy to be found.
OBJECTIVE: To investigate the prevalence, distribution characteristics and influencing factors of hypertension among school students aged 6-18 years in Hainan Province, so as to provide a theoretical basis for early and precise prevention and intervention.
METHODS: The health monitoring data of school students in 18 cities and counties in Hainan Province from 2013 to 2020 were collected. A total of 6 253 567 pieces of information were included, including 3 408 734 (54.51%) pieces of information for boys and 2 844 833 (45.49%) pieces of information for girls. The Blood Pressure Reference Standards for Sex, Age and Height of Chinese Children Aged 3-17 Years, the 2018 Revised Guidelines for Prevention and Treatment of Hypertension in China, Screening Cut-Off Values for Overweight and Obesity in School-Aged Children and Adolescents WS_ T586-2018, High Waist Circumference Screening Cut-Off Values for Children and Adolescents Aged 7 To 18 Years WS_T611-2018, and Comprehensive Evaluation of the Developmental Level of Children and Adolescents were used to detect blood pressure of children and adolescents aged 6-17 years, blood pressure, body mass index, waist circumference and spirometry index of adolescents aged 18 years. Whether to be abdominal obesity adopts the international recommended criteria, that is, the waist circumference and height ratio ≥ 0.5 is abdominal obesity. Spearman analysis and multinomial logistic regression analysis were used to analyze the correlation between body mass index, waist circumference, waist-to-height ratio, spirometry index and blood pressure and the risk factors.
RESULTS AND CONCLUSION: The distribution of hypertension in school students aged 6-18 years in Hainan Province has the following characteristics: (1) The distribution of hypertension in children and adolescents has regional clustering, and the severity of blood pressure from high to low is in the south, east, west, center, and north. (2) There were significant differences in the degree of hypertension between boys and girls at different ages (P < 0.001). The detection rate of elevated blood pressure in boys after 13 years of age increased significantly than that in girls. The detection rate of stage 1 hypertension in boys increased significantly after 14 years of age. The severity of blood pressure in girls aged 6-13 years was higher than that in boys, and the severity of blood pressure in boys aged 14-17 years was higher than that in girls. (3) Multivariate logistic regression analysis results showed that female students [odds ratio (OR)=1.185, 95% confidence interval (CI): 1.180-1.189, P < 0.001], body mass index (overweight OR=1.144, 95% CI: 1.135-1.154, P < 0.001; obesity OR=1.120, 95% CI: 1.105-1.135, P < 0.001), waist circumference (high normal waist circumference OR=1.053, 95% CI: 1.046-1.061, P < 0.001; high waist circumference OR=1.025, 95% CI: 1.012-1.037, P < 0.001) and waist-to-height ratio (OR=1.286, 95% CI: 1.270-1.303, P < 0.001) were risk factors for hypertension in children and adolescents. Age, spiro-index (middle level: OR=0.956, 95% CI: 0.944-0.968, P < 0.001); middle and upper level: OR=0.869, 95% CI: 0.8588-0.880, P < 0.001; first-class level: OR=0.739, 95% CI: 0.726-0.753, P < 0.001) were protective factors for hypertension in children and adolescents. A higher spirometry index level indicated a lower risk of hypertension in children and adolescents. (4) The above data indicate that the detection rate of hypertension in school students aged 6-18 years is relatively high in Hainan province. Region, year, age, sex, body mass index, waist circumference, abdominal obesity, and spirometry index are all influencing factors for the detection rate of hypertension in children and adolescents. Body mass index, waist circumference and waist-to-height ratio should be controlled within the normal range in children and adolescents aged 6-18 years. Increasing spirometry index levels is an important tool for blood pressure control in children and adolescents. 

Key words: Hainan Province, children and adolescents, hypertension, detection rate, influencing factor, body mass index, waist circumference, waist-to-height ratio, spirometry index

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