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Article(id=1241065978772115525, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202408356, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1724601600000, receivedDateStr=2024-08-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773822787229, onlineDateStr=2026-03-18, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773822787229, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773822787229, creator=13701087609, updateTime=1773822787229, updator=13701087609, issue=Issue{id=1241065978004557893, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773822787047, creator=13701087609, updateTime=1773823194927, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067688831808347, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067688831808348, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=648, endPage=653, ext={EN=ArticleExt(id=1241065979048939593, articleId=1241065978772115525, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Correlation analysis of handgrip strength with blood pressure and vital capacity of primary school students, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To comprehend the correlation between handgrip strength and blood pressure as well as vital capacity among pupils in Shiyan City, and furnish a scientific basis for pupils to prevent heart and lung diseases.

Methods

In November 2023, a cluster random sampling method was used to measure the height, weight, handgrip strength, blood pressure, vital capacity and other indicators of 1 263 primary school students aged 6-12 years in Shiyan City, Hubei Province. Spearman correlation analysis was used to analyze the correlation between handgrip strength and blood pressure and vital capacity. Quantile regression model was used to analyze the correlation degree of handgrip strength with blood pressure and vital capacity at different quantiles.

Results

A total of 1 263 students aged 6-12 years old were investigated in Shiyan city, including 658 boys and 605 girls. The systolic blood pressure(Z=-3.280), vital capacity(Z=-7.015)and handgrip strength(Z=-5.675)of boys were higher than those of girls (all P<0.05). There was no significant difference in diastolic blood pressure between boys and girls (P>0.05). There were significant differences in systolic blood pressure, diastolic blood pressure, vital capacity and handgrip strength between pupils of different ages and places of residence (all P<0.05). Spearman correlation analysis showed that handgrip strength was positively correlated with systolic blood pressure (r=0.390), diastolic blood pressure (r=0.271) and vital capacity (r=0.636) (all P<0.01). Quantile regression analysis showed that systolic blood pressure increased with the increase of handgrip strength, and the difference was statistically significant (P<0.05). The regression coefficient of handgrip strength was the lowest at the 95th percentile of diastolic blood pressure (β=0.222, 95% CI: -0.139-0.583). Except for the 95th percentile, the regression coefficient of handgrip strength and diastolic blood pressure was statistically significant at the other percentiles (P<0.05). The regression coefficient of handgrip strength was the highest at the 50th quantile of vital capacity (β =59.881, 95% CI: 51.456-68.306), and the correlation between handgrip strength and vital capacity at each quantile was statistically significant (P<0.05).

Conclusion

Handgrip strength is positively correlated with blood pressure and vital capacity. Different levels of handgrip strength have different effects on blood pressure and vital capacity in primary school students. Handgrip strength can be used as an index to reflect blood pressure and vital capacity.

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目的

了解十堰市小学生握力与血压、肺活量的相关性，为小学生预防心肺疾病提供科学依据。

方法

2023年11月采取整群随机抽样的方法，对湖北省十堰市1 263名6~12岁小学生进行身高、体重、握力、血压、肺活量等指标测量。采用Spearman相关性分析握力与血压、肺活量的相关关系，分位数回归模型分析不同分位点握力与血压、肺活量相关性影响程度。

结果

本研究共调查十堰市1 263名6~12岁小学生，男生658人，女生605人。男生收缩压（Z=-3.280）、肺活量（Z=-7.015）及握力（Z=-5.675）均高于女生（均P<0.05），男女生间舒张压差异不明显（P>0.05）；不同年龄、不同居住地的小学生收缩压、舒张压、肺活量及握力差异均有统计学意义（均P<0.05）。Spearman相关性分析结果显示，小学生握力与收缩压（r=0.390）、舒张压（r=0.271）、肺活量（r=0.636）均呈正向相关（均P<0.01）。分位数回归分析发现，随着握力增加收缩压增大，且有统计学意义（P<0.05）；舒张压在95分位点握力回归系数最低（β=0.222，95% CI:-0.139～0.583），除了在95分位点外，其他各分位点握力与舒张压均有统计学意义（P<0.05）；肺活量在50分位点握力回归系数最高（β=59.881，95% CI:51.456～68.306），各分位点握力与肺活量均有统计学意义（P<0.05）。

结论

握力与血压、肺活量均呈正相关，在小学生中不同水平握力对血压、肺活量的影响不同，握力可作为反映血压、肺活量的指标进一步推广。

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逯雨，E-mail：
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=U801RK3WeonSX+c7PhAfWA==, magXml=b2wA3aSKqhtyOIPdozsJ9g==, pdfUrl=null, pdf=aD00COSQO2XXtRT5He0+xg==, pdfFileSize=705292, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=kkdrssvtxbhQJGr5Ztd78g==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=KcLPDygvVwLXGOgq9Px3Aw==, mapNumber=null, authorCompany=null, fund=null, authors=

程梦晗（1999—），女，硕士在读，研究方向：疾病预防与控制

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程梦晗（1999—），女，硕士在读，研究方向：疾病预防与控制

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程梦晗（1999—），女，硕士在读，研究方向：疾病预防与控制

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(In Chinese), articleTitle=Study of the association between handgrip strength and forced vital capacity in young university students with quantile regression, refAbstract=null)], funds=[Fund(id=1241065986401554749, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, awardId=B2022497, language=CN, fundingSource=湖北省教育厅科学研究计划项目(B2022497), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241065979980075101, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, xref=null, ext=[AuthorCompanyExt(id=1241065979984269406, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, companyId=1241065979980075101, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, Hubei 442000, China), AuthorCompanyExt(id=1241065979992658015, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, companyId=1241065979980075101, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=湖北医药学院公共卫生与健康学院，湖北 十堰 442000)])], figs=[ArticleFig(id=1241065984178573581, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, language=EN, label=Fig.1, caption=Correlation analysis of physical fitness measurement data such as handgrip strength, blood pressure and vital capacity among primary school students, figureFileSmall=rGUws/AiEBvDegjpriDngw==, figureFileBig=kkdrssvtxbhQJGr5Ztd78g==, tableContent=null), ArticleFig(id=1241065984279236883, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, language=CN, label=图1, caption=小学生体质测量信息、握力与血压、肺活量的相关性分析

注：*P<0.05，**P<0.01。

, figureFileSmall=rGUws/AiEBvDegjpriDngw==, figureFileBig=kkdrssvtxbhQJGr5Ztd78g==, tableContent=null), ArticleFig(id=1241065984526700827, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, language=EN, label=Table 1, caption=

Baseline Characteristics of primary school students[M(P25,P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标人数统计值身高（cm）体重（kg）收缩压（mmHg）
性别
男658140.4(131.9,146.4)33.8(27.9,42.1)102.0(93.8,111.0)
女605140.1(131.5,148.1)32.2(25.9,39.9)99.0(91.0,109.0)
Z值-0.067-3.054-3.280
P值0.9460.0020.001
年龄（岁）
625120.9(117.2,123.4)21.9(19.4,23.4)92.0(87.0,100.0)
7119123.4(119.7,127.3)23.3(20.9,25.4)92.0(86.0,101.0)
8124128.7(124.7,132.2)24.9(22.7,29.3)95.0(88.0,102.0)
9247135.7(132.0,140.8)29.9(26.6,35.5)100.0(94.0,109.0)
10330141.3(136.9,146.1)34.8(29.5,41.8)103.0(93.0,111.0)
11323147.0(142.6,152.8)39.4(33.5,46.5)103.0(96.0,112.0)
1295151.9(146.6,157.0)41.7(36.3,49.7)106.0(95.0,114.0)
H值767.245529.583112.240
P值<0.001<0.001<0.001
城乡
城市530143.8(138.8,149.8)38.0(31.6,45.3）104.0(96.0,112.0）
乡村733135.6(127.2,143.9）29.4(24.4,36.4）99.0(90.0,108.0）
Z值-13.405-14.254-7.009
P值<0.001<0.001<0.001
指标人数统计值舒张压（mmHg）肺活量（ml）握力（kg）
性别
男65866.0(59.0,7.0)1 898.5(1 486.8,2 311.3)14.7(12.0,17.6)
女60564.0(58.0,71.0)1 589.0(1 191.5,2 086.0)13.3(10.6,16.6)
Z值-1.660-7.015-5.676
P值0.097<0.001<0.001
年龄（岁）
62559.0(54.0,63.5)921.0(737.0,1172.0)7.9(7.0,9.6)
711960.0(54.0,65.0)952.0(724.0,1 243.0)9.6(7.9,12.0)
812461.0(56.0,67.8)1 220.5(991.0,1 534.3)10.5(9.2,12.2)
924765.0(60.0,71.0)1 678.0(1 412.0,1 996.0)13.1(11.0,15.3)
1033066.0(59.0,73.0)1 900.0(1 518.3,2 231.3)14.6(12.5,16.8)
1132366.0(61.0,72.0)2 141.0(1 774.0,2 467.0)16.7(14.4,19.6)
129568.0(61.0,73.0)2 147.0(1 591.0,2 577.0)20.0(17.2,22.0)
H值101.452480.761560.211
P值<0.001<0.001<0.001
城乡
城市53068.0(63.0,74.0）2 110.0(1 742.5,2 453.3）15.3(12.7,18.2）
乡村73363.0(57.0,68.5）1 492.0(1 117.0,1 871.0）13.1(10.4,16.0）
Z值-11.102-17.194-8.844
P值<0.001<0.001<0.001
), ArticleFig(id=1241065986053427495, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, language=CN, label=表1, caption=

小学生基线特征[M(P25,P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标人数统计值身高（cm）体重（kg）收缩压（mmHg）
性别
男658140.4(131.9,146.4)33.8(27.9,42.1)102.0(93.8,111.0)
女605140.1(131.5,148.1)32.2(25.9,39.9)99.0(91.0,109.0)
Z值-0.067-3.054-3.280
P值0.9460.0020.001
年龄（岁）
625120.9(117.2,123.4)21.9(19.4,23.4)92.0(87.0,100.0)
7119123.4(119.7,127.3)23.3(20.9,25.4)92.0(86.0,101.0)
8124128.7(124.7,132.2)24.9(22.7,29.3)95.0(88.0,102.0)
9247135.7(132.0,140.8)29.9(26.6,35.5)100.0(94.0,109.0)
10330141.3(136.9,146.1)34.8(29.5,41.8)103.0(93.0,111.0)
11323147.0(142.6,152.8)39.4(33.5,46.5)103.0(96.0,112.0)
1295151.9(146.6,157.0)41.7(36.3,49.7)106.0(95.0,114.0)
H值767.245529.583112.240
P值<0.001<0.001<0.001
城乡
城市530143.8(138.8,149.8)38.0(31.6,45.3）104.0(96.0,112.0）
乡村733135.6(127.2,143.9）29.4(24.4,36.4）99.0(90.0,108.0）
Z值-13.405-14.254-7.009
P值<0.001<0.001<0.001
指标人数统计值舒张压（mmHg）肺活量（ml）握力（kg）
性别
男65866.0(59.0,7.0)1 898.5(1 486.8,2 311.3)14.7(12.0,17.6)
女60564.0(58.0,71.0)1 589.0(1 191.5,2 086.0)13.3(10.6,16.6)
Z值-1.660-7.015-5.676
P值0.097<0.001<0.001
年龄（岁）
62559.0(54.0,63.5)921.0(737.0,1172.0)7.9(7.0,9.6)
711960.0(54.0,65.0)952.0(724.0,1 243.0)9.6(7.9,12.0)
812461.0(56.0,67.8)1 220.5(991.0,1 534.3)10.5(9.2,12.2)
924765.0(60.0,71.0)1 678.0(1 412.0,1 996.0)13.1(11.0,15.3)
1033066.0(59.0,73.0)1 900.0(1 518.3,2 231.3)14.6(12.5,16.8)
1132366.0(61.0,72.0)2 141.0(1 774.0,2 467.0)16.7(14.4,19.6)
129568.0(61.0,73.0)2 147.0(1 591.0,2 577.0)20.0(17.2,22.0)
H值101.452480.761560.211
P值<0.001<0.001<0.001
城乡
城市53068.0(63.0,74.0）2 110.0(1 742.5,2 453.3）15.3(12.7,18.2）
乡村73363.0(57.0,68.5）1 492.0(1 117.0,1 871.0）13.1(10.4,16.0）
Z值-11.102-17.194-8.844
P值<0.001<0.001<0.001
), ArticleFig(id=1241065986154090799, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, language=EN, label=Table 2, caption=

Quantile regression analysis on handgrip strength, blood pressure and vital capacity among primary school students

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分位数β值(95% CI)标准误P值
收缩压P50.761（0.314～1.209）0.228<0.001
P100.806（0.535～1.078）0.139<0.001
P250.890（0.643～1.137）0.126<0.001
P501.005（0.769～1.241）0.120<0.001
P751.057（0.825～1.288）0.118<0.001
P901.081（0.728～1.435）0.180<0.001
P951.107（0.585～1.628）0.266<0.001
舒张压P50.307（0.012～0.603）0.1510.041
P100.228（0.016～0.440）0.1080.035
P250.290（0.123～0.456）0.0850.001
P500.417（0.249～0.584）0.085<0.001
P750.435（0.245～0.624）0.097<0.001
P900.361（0.061～0.662）0.1530.018
P950.222（-0.139～0.583）0.1840.227
肺活量P550.674（34.979～66.370）8.000<0.001
P1055.400（39.976～70.824）7.862<0.001
P2557.584（48.889～66.279）4.432<0.001
P5059.881（51.456～68.306）13.719<0.001
P7559.838（51.399～68.276）4.301<0.001
P9059.130（47.869～70.392）5.740<0.001
P9554.235（37.320～71.151）8.622<0.001
), ArticleFig(id=1241065986254754098, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065978772115525, language=CN, label=表2, caption=

小学生握力与血压、肺活量的分位数回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分位数β值(95% CI)标准误P值
收缩压P50.761（0.314～1.209）0.228<0.001
P100.806（0.535～1.078）0.139<0.001
P250.890（0.643～1.137）0.126<0.001
P501.005（0.769～1.241）0.120<0.001
P751.057（0.825～1.288）0.118<0.001
P901.081（0.728～1.435）0.180<0.001
P951.107（0.585～1.628）0.266<0.001
舒张压P50.307（0.012～0.603）0.1510.041
P100.228（0.016～0.440）0.1080.035
P250.290（0.123～0.456）0.0850.001
P500.417（0.249～0.584）0.085<0.001
P750.435（0.245～0.624）0.097<0.001
P900.361（0.061～0.662）0.1530.018
P950.222（-0.139～0.583）0.1840.227
肺活量P550.674（34.979～66.370）8.000<0.001
P1055.400（39.976～70.824）7.862<0.001
P2557.584（48.889～66.279）4.432<0.001
P5059.881（51.456～68.306）13.719<0.001
P7559.838（51.399～68.276）4.301<0.001
P9059.130（47.869～70.392）5.740<0.001
P9554.235（37.320～71.151）8.622<0.001
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小学生握力与血压、肺活量的相关性分析
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程梦晗 , 方雯 , 张苗 , 潘悦 , 陈胜依 , 逯雨
现代预防医学 | 儿少卫生与妇幼保健 2025,52(4): 648-653
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现代预防医学 | 儿少卫生与妇幼保健 2025, 52(4): 648-653
小学生握力与血压、肺活量的相关性分析
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程梦晗, 方雯, 张苗, 潘悦, 陈胜依, 逯雨
作者信息
  • 湖北医药学院公共卫生与健康学院，湖北 十堰 442000

    • 程梦晗（1999—），女，硕士在读，研究方向：疾病预防与控制

通讯作者:

逯雨，E-mail：
Correlation analysis of handgrip strength with blood pressure and vital capacity of primary school students
Meng-han CHENG, Wen FANG, Miao ZHANG, Yue PAN, Sheng-yi CHEN, Yu LU
Affiliations
  • Department of Preventive Medicine, School of Public Health, Hubei University of Medicine, Shiyan, Hubei 442000, China
出版时间: 2025-02-25 doi: 10.20043/j.cnki.MPM.202408356
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摘要
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目的

了解十堰市小学生握力与血压、肺活量的相关性，为小学生预防心肺疾病提供科学依据。

方法

2023年11月采取整群随机抽样的方法，对湖北省十堰市1 263名6~12岁小学生进行身高、体重、握力、血压、肺活量等指标测量。采用Spearman相关性分析握力与血压、肺活量的相关关系，分位数回归模型分析不同分位点握力与血压、肺活量相关性影响程度。

结果

本研究共调查十堰市1 263名6~12岁小学生，男生658人，女生605人。男生收缩压（Z=-3.280）、肺活量（Z=-7.015）及握力（Z=-5.675）均高于女生（均P<0.05），男女生间舒张压差异不明显（P>0.05）；不同年龄、不同居住地的小学生收缩压、舒张压、肺活量及握力差异均有统计学意义（均P<0.05）。Spearman相关性分析结果显示，小学生握力与收缩压（r=0.390）、舒张压（r=0.271）、肺活量（r=0.636）均呈正向相关（均P<0.01）。分位数回归分析发现，随着握力增加收缩压增大，且有统计学意义（P<0.05）；舒张压在95分位点握力回归系数最低（β=0.222，95% CI:-0.139～0.583），除了在95分位点外，其他各分位点握力与舒张压均有统计学意义（P<0.05）；肺活量在50分位点握力回归系数最高（β=59.881，95% CI:51.456～68.306），各分位点握力与肺活量均有统计学意义（P<0.05）。

结论

握力与血压、肺活量均呈正相关，在小学生中不同水平握力对血压、肺活量的影响不同，握力可作为反映血压、肺活量的指标进一步推广。

握力  /  血压  /  肺活量  /  小学生  /  分位数回归
Objective

To comprehend the correlation between handgrip strength and blood pressure as well as vital capacity among pupils in Shiyan City, and furnish a scientific basis for pupils to prevent heart and lung diseases.

Methods

In November 2023, a cluster random sampling method was used to measure the height, weight, handgrip strength, blood pressure, vital capacity and other indicators of 1 263 primary school students aged 6-12 years in Shiyan City, Hubei Province. Spearman correlation analysis was used to analyze the correlation between handgrip strength and blood pressure and vital capacity. Quantile regression model was used to analyze the correlation degree of handgrip strength with blood pressure and vital capacity at different quantiles.

Results

A total of 1 263 students aged 6-12 years old were investigated in Shiyan city, including 658 boys and 605 girls. The systolic blood pressure(Z=-3.280), vital capacity(Z=-7.015)and handgrip strength(Z=-5.675)of boys were higher than those of girls (all P<0.05). There was no significant difference in diastolic blood pressure between boys and girls (P>0.05). There were significant differences in systolic blood pressure, diastolic blood pressure, vital capacity and handgrip strength between pupils of different ages and places of residence (all P<0.05). Spearman correlation analysis showed that handgrip strength was positively correlated with systolic blood pressure (r=0.390), diastolic blood pressure (r=0.271) and vital capacity (r=0.636) (all P<0.01). Quantile regression analysis showed that systolic blood pressure increased with the increase of handgrip strength, and the difference was statistically significant (P<0.05). The regression coefficient of handgrip strength was the lowest at the 95th percentile of diastolic blood pressure (β=0.222, 95% CI: -0.139-0.583). Except for the 95th percentile, the regression coefficient of handgrip strength and diastolic blood pressure was statistically significant at the other percentiles (P<0.05). The regression coefficient of handgrip strength was the highest at the 50th quantile of vital capacity (β =59.881, 95% CI: 51.456-68.306), and the correlation between handgrip strength and vital capacity at each quantile was statistically significant (P<0.05).

Conclusion

Handgrip strength is positively correlated with blood pressure and vital capacity. Different levels of handgrip strength have different effects on blood pressure and vital capacity in primary school students. Handgrip strength can be used as an index to reflect blood pressure and vital capacity.

Handgrip strength  /  Blood pressure  /  Vital capacity  /  Primary school students  /  Quantile regression
程梦晗, 方雯, 张苗, 潘悦, 陈胜依, 逯雨. 小学生握力与血压、肺活量的相关性分析. 现代预防医学, 2025 , 52 (4) : 648 -653 . DOI: 10.20043/j.cnki.MPM.202408356
Meng-han CHENG, Wen FANG, Miao ZHANG, Yue PAN, Sheng-yi CHEN, Yu LU. Correlation analysis of handgrip strength with blood pressure and vital capacity of primary school students[J]. Modern Preventive Medicine, 2025 , 52 (4) : 648 -653 . DOI: 10.20043/j.cnki.MPM.202408356
正文
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握力(Handgrip strength, HGS)是手指紧握物体时所产生的力量总和，是手部精细动作发育的重要参考指标，反映前臂外侧肌群、手内肌群力量和运动能力[1]。此外，握力与全身肌肉的协调性也有关，儿童青少年时期握力相较于身高、体重、BMI等体格指标能更早地提示儿童肌肉质量变化，反映骨骼肌水平（瘦体重的增加和体脂肪的减少）的变化状态，可作为评估儿童身体机能变化和心血管疾病的重要指标[2-4]。
握力作为衡量肌肉功能的指标有效提示成人心血管疾病风险[5]。前瞻性城乡流行病学研究课题组对欧美和中国大量人群的队列研究结果表明较低的握力水平在不同性别人群以及不同经济水平地域均与较高的心血管疾病风险存在稳定的关联[6-9]。儿童青少年正处于生长发育的关键期，其生命早期肌肉力量的变化是否也与心血管变化有一定的关联。近年来，大量研究证实了儿童青少年握力与血压的相关性，但结论存在差异。有研究表明儿童握力与血压值呈正相关，但也有相反的结论，其肌肉力量与心血管间的相关性和机制还有待进一步研究[10-11]。肺活量是反映肺功能发育状况的重要指标，研究发现握力与肺功能存在关联，可间接评估老年人和慢性阻塞性肺病患者的心肺功能[12-13]。儿童青少年生长发育过程中肌肉力量和心肺功能也在发生变化，各指标的变化状态和相关性也为促进儿童健康成长和疾病预防预测起到指导作用。本研究以湖北省十堰市6~12岁小学生为研究对象，探讨握力与血压、肺活量间的关联，为儿童心肺疾病预防干预措施提供一定的依据。
1　对象与方法
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1.1　对象
于2023年11月，采用整群随机抽样方法抽取十堰市郧阳区2所小学，从每所学校一至六年级中各随机抽取2个班级，每个班级选择6～12岁学生作为研究对象，共获取1 273名学生数据，剔除体检表信息不全者，最终纳入1 263人。其中男生658人（52.10%），女生605人（47.90%）。本研究经过湖北医药学院伦理审查委员会的批准（编号：2023-RE-029），参与调查的学生及家长均签署知情同意书。
1.2　方法
1.2.1　握力测量
使用 CAMRY 握力仪进行握力测量，测量时研究对象取直立位，双臂斜下垂，左右手掌心向内，手握握力上下握柄，测试人员按下握力计的开关，研究对象左右手全力握紧把柄，左右手连续测试3次，取最大值作为最终握力值，测试值以kg为单位。
1.2.2　血压测量
要求受试者安静休息至少5 min后开始测量坐位上臂血压，上臂应置于心脏水平。血压测量采用680CR-680B 电子血压计 [鱼跃（江苏）有限公司]，每位受试者测量2次，间隔2 min，若收缩压或舒张压的2次读数相差>10 mmHg，则测量第3次，取血压值相近的2次测量结果求平均值。
1.2.3　肺活量
使用CHEST HI-101便携式肺功能仪进行测量，研究对象直立位，先做一两次扩胸动作，然后尽力深吸气，吸满后憋住气，再向肺活量计口嘴中等速度尽力深呼气，直到不能再呼气为止读数，测3次，选最大值记录。
1.3　质量控制
挑选合格的调查人员并统一培训体检仪器使用方法，现场调查时用同型号仪器进行测量，测量前校正仪器并在调查过程中随机进行质控。
1.4　统计学方法
使用EpiData 3.1对调查数据进行双录入并核查。使用SPSS 27和Origin 2021进行统计分析。因小学生基线特征指标不符合正态分布，故本研究计量资料采用M（P25,P75）表示，两组间比较采用Wilcoxon秩和检验方法，多个组间比较用 Kruskal-Wallis H检验；采用Spearman相关分析握力与血压、肺活量的相关关系；通过分位数回归模型分析血压、肺活量在P5、P10、P25、P50、P75、P90、P95下，握力与血压、肺活量的关联。检验水准α=0.05。
2　结果
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2.1　小学生基线特征
结果显示，调查对象主要是6~12岁小学生，男生658人（52.1%），女生605人（47.9%），其中6岁25人（2%），7岁119人（9.4%），8岁124人（9.8%），9岁247人（19.6%），10岁330人（26.1%），11岁323人（25.6%），12岁95人（7.5%），城市学生530人（42.0%），乡村学生733人（58.0%）。男生身高、体重、收缩压、肺活量及握力均高于女生（P<0.05），男女生间身高、舒张压差异不明显（P>0.05）。不同年龄小学生身高、体重、收缩压、舒张压、肺活量及握力均有统计学意义（P<0.05），握力随着年龄的增长不断增加，除6~8岁间差异无统计学意义外，其他各年龄组差异均有统计学意义（P<0.05）。城市小学生身高、体重、收缩压、舒张压、肺活量及握力均高于乡村小学生，且差异均有统计学意义（P<0.05）。见表1。
2.2　小学生体质测量信息、握力与血压、肺活量相关性分析
相关分析结果显示，握力与收缩压（r =0.390）、舒张压（r =0.271）、肺活量（r =0.636）均呈正相关（P<0.01）；握力与年龄（r =0.658）、性别（男=1，女=2）（r =-0.160）、城乡（城市=1，乡村=2）（r =-0.249）、身高（r =0.744）、体重（r =0.683）均相关（P<0.01）。见图1。
2.3　握力与血压、肺活量的分位数回归分析
调整性别、年龄、城乡因素，分别以收缩压、舒张压、肺活量为因变量，以握力为自变量进行分位数回归分析。由表2可知，随着握力增加收缩压增大，各分位点下握力对收缩压影响均有统计学意义（P<0.05）；舒张压在95分位点握力回归系数最低（β=0.222），在75分位点握力回归系数最高（β=0.435），除了在95分位点外，其他各分位点握力与舒张压均有统计学意义（P<0.05）；在肺活量中握力回归系数依次递增至50分位点，在50分位点最大（β=58.881），50分位点之后依次降低，呈反“U”型，不同分位点握力对肺活量影响均有统计学意义（P<0.05）。
3　讨论
收起
本研究结果显示小学生握力随年龄的增长而增加，这与北京市6~16岁儿童的调查结果一致[14]。握力存在性别差异，男生握力高于女生，与国内外不同性别握力比较研究结果一致[15-16]。这可能由于先天条件的差异，包括激素水平的变化、手部形态差异，同时也与体力活动有关[17]。城市小学生握力高于乡村小学生，刘炜达研究发现高握力人群主要住在城市，居住在农村的人群握力较低[7]。可能是由于社会经济的发展，城市小学生更注重体能训练和身体锻炼，而农村小学生不再参与农田劳动并且课余的体育活动较少，身体机能相较于城市学生有所降低，此外饮食结构也是重要影响因素，农村学生的饮食营养水平相对城市学生稍低，蛋白和肉类的摄入相对不足，在城市、农村小学生身高、体重的差异中同样体现。
本研究中小学生握力与身高、体重均呈正相关，与其他研究结果一致[18-19]。考虑到随着身高体重增长肌肉力量增大的原因。本研究小学生握力与血压呈正相关，这与Zhang等研究的美国儿童青少年的结果一致，发现握力增加，血压值也增大[20]。赵苗苗等也发现辽宁省13~18岁儿童青少年握力与血压呈正相关[21]。提示儿童青少年肌肉骨骼系统生长发育的同时血压也在增长。造成这一结果的原因可能是儿童青少年成长中肌肉量的增加代谢需求增大，而代谢需求是通过增加心输出量来实现的。研究表明老年人握力和血压关系与儿童青少年不同，老年人肌肉力量增加与血压呈负相关[22-23]。这是因为年龄越大，肌肉量减少，加强抗阻训练能有效改善血管舒张性交感神经调节[24]。
本研究发现小学生握力与肺活量呈正相关关系，表明小学生在肌肉力量增加的同时，肺功能也更健全。这一结论与罗予等进行的大学生握力与肺活量相关性的横断面研究一致[25]。与小学生相比，大学生握力与肺活量的相关性更稳定，大学生的身体发育成熟，规律的锻炼通常会增强握力和肺活量。握力被认为是诊断肌肉减少症的关键指标，Tomita Y等发现老年人肌肉减少症与肺活量下降相关[26-28]。考虑到老年人健康状况不稳定可能使握力与肺活量的正相关关系变得复杂。提示小学生、大学生和老年人握力与肺活量相关性强度和稳定性因年龄和生理状态的不同而异，表明不同人群在握力与肺活量的相关性上展现了不同的特征和规律，因此，未来的研究应关注不同人群之间的体能相关性，以更全面地探讨握力与肺活量的关系。
分位数回归模型具有较强的稳健性，可以根据特定的分位点对数据进行分段分析，从而捕捉不同层次数据的全面信息[29]。本文采用分位数回归模型分析发现，随着收缩压（分位数）的增加，握力与收缩压的关联强度增强，表明握力对收缩压影响程度的变化趋势呈线性关系。其中握力对高分位数人群比对低分位数人群的收缩压影响程度要强，提示高分位数小学生可能具备更强的肌肉发育和心血管健康,建议低分位数小学生加强体育锻炼，提高手部和上肢力量。在95分位点中握力对舒张压的影响程度最弱，除了95分位点外，其他分位点握力与舒张压相关性存在统计学意义。不同水平握力与肺活量的相关性存在统计学意义，其中在50分位点之前，各分位点握力回归系数逐渐增大，当在50分位点时握力回归系数最高，表明握力对肺活量的影响在中端表现得最为明显。提示握力处于中端水平的儿童在进行体能训练或改善肺活量时，可能会有更大的提升效果。与刘凤东等人研究的握力与肺活量关系的研究结果相似[30]。这一结果意味着握力对收缩压、舒张压、肺活量的影响在各分位点上是不同的，因此，应充分考虑收缩压、舒张压、肺活量的分位数水平，对不同血压、肺活量状况的小学生采取不同的健康促进策略。
综上所述，本研究初步探究了小学生握力与血压、肺活量的相关性，不仅发现在总体上握力与收缩压、舒张压、肺活量均呈正相关，而且不同分位点握力与血压、肺活量的相关性影响程度不同，更加全面的描述了握力与血压、肺活量关联程度的分布。提示握力可作为评估小学生早期预防心肺疾病的一个简易指标。但研究也存在不足之处，本研究为横断面研究，无法判断握力与血压、肺活量之间的因果关系，之后的研究应进一步开展高质量队列研究，动态监测握力、血压和肺活量的变化，为小学生健康成长提供更多的建议。
基金
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  • 湖北省教育厅科学研究计划项目(B2022497)
文献
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2025年第52卷第4期
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doi: 10.20043/j.cnki.MPM.202408356
  • 接收时间：2024-08-26
  • 首发时间：2026-03-18
  • 出版时间：2025-02-25
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  • 收稿日期：2024-08-26
基金
湖北省教育厅科学研究计划项目(B2022497)
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    湖北医药学院公共卫生与健康学院，湖北 十堰 442000

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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