少年高血壓危險因子及後續影響

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 公共衛生學院 > 環境醫學研究所(已停用) > 研究計畫 > Item 310903500/25243

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題名:	少年高血壓危險因子及後續影響 Childhood Hypertension and Subsequent Effects
作者:	宋鴻樟;許秀卿;蘇大成;簡國龍;林瑞雄;李源德;王主科
貢獻者:	中國醫藥大學環境醫學研究所
關鍵詞:	少年;高血壓;危險因子;childhood;hypertension;risk factor
日期:	2006-12
上傳時間:	2010-07-15 16:19:22 (UTC+8)
摘要:	高血壓是國人最盛行的疾病，而相關的中風乃國人第二大死因。相較成人，小孩的高血壓較不盛行。但近年來，小孩高血壓越來越盛行。甚至每年有60到100位未成年因為中風死亡。顯示小孩高血壓已成為重要健康問題。根據1992到2000年間的中小學生尿液篩檢計畫，有8401案小學生的明顯高血壓和4229案嚴重高血壓篩檢出來。有嚴重高血壓孩子，有蛋白尿和糖尿的機率高。本計畫擬建立一個由1995到2000年間中小學生尿液篩檢的800位高血壓孩子和800位正常血壓孩子族群，以探討小孩高血壓的危險因子，家族簇集現象及治療效果，包括血壓控制不良的後果。這兩組小孩都在一項尿液篩檢中有過蛋白尿及/或糖尿陽性的記錄。本計畫將達成如下目標： 1.建立研究、操作及資料收集程序。 2.建立經由尿液篩檢鑑知的高血壓和正常血壓組成的追蹤族群。 3.以問卷訪視及體檢比較兩組學生，探討高血壓的原因。 4.探討學生治療照護的情形及效果，提供必要協助。 5.探討研究期間的健康變化，及影響因子。由於本研究對象是經由尿液篩檢有過2次蛋白尿或/及糖尿陽性的學生，因此這些有高血壓及正常血壓的學生，受限於取樣產生的偏差，並不能代表一般血壓高及血壓正常的同齡學生。然而，所取樣的學生卻比一般小孩有更高的危險會衍生心血管及腎的病變，乃更需立即照護的一群。本計畫將提供合宜的方法探討兒童高血壓、糖尿及尿蛋白的交互作用，研擬防治對策。本計畫在國家衛生院的支持期滿之後，將繼續追蹤，不僅提供後續照護及諮詢，也能更精確探討這些學生的健康維護必要措施，符合預防醫學倫理及原則。 Hypertension is the most prevalent disease in our population with stroke the second leading cause of deaths. Hypertension has a relatively low prevalence in children. But, there are a number of children being suffered from this problem in significance. There were 60-100 deaths annually from stroke before the age of 20 years in Taiwan. In the mass urine screening program conducted in 1992 through 2000 for elementary students, 8401 children with significant hypertension, 4229 with severe hypertension had been identified. Students with severe hypertension were more likely to have proteinuria and glucosuria. This proposed study will establish a cohort based on these hypertensive students (n=800) and students without hypertension (n=800), randomly selected from the 1995-2000 mass urine screening population. Both groups of students have been found to be glucosuria and/or proteinuria positive in a urine screening program. We would like to investigate the risk factors associated with childhood hypertension, family cluster and the treatment effectiveness and different levels of blood pressure (BP) control in showing the progression of cardiovascular disease (CVD) and renal diseases and other comobidity in hypertensive children. This study as a feasibility study has the following aims. 1. To create a protocol, an operation manual and data collection form. 2. To establish a cohort consists of hypertensive children and normotensive children (controls) identified from mass urine screening for elementary students. 3. To conduct a questionnaire investigation and health examination for factors that may associate with childhood hypertension by comparing hypertensive group and control group. 4. To assess patient compliance with their treatment protocol, including clinic visit schedules, medications and other procedures. 5. To observe any short-term adverse effects in the 3-year study period. 6. To obtain risks within patient variation in comobidity during the baseline and follow-up period. 7. To compare differences in blood/urine chemistry and lifestyle between children with and with no new comobidity. This study population based on a mass urine screening for glucosuria or/and proteinuria in children may have limitations generated from selection bias. The BP status may not represent general children. However, these children are at elevated risk of developing comobidity in cardiovascular and renal systems, they are a group children deserve immediate cares. This project will provide a prominent approach for identifying risks in the interaction of hypertension glucosuria and proteinuria, and identifying ways to prevent the development of comobidity. Based on the past experience in Chin-Shan Community Cardiovascular Cohort Study, the investigators would like to continue the follow-up task for the study subjects by the end of NHRI support. In doing so, all study subjects will continue to receive adequate care and consultation, the investigators will be able to precisely estimate the risk may occur in the treatment effectiveness.
顯示於類別:	[環境醫學研究所(已停用)] 研究計畫

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