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Article(id=1325531969676927008, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325531848021140417, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025324, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1751558400000, receivedDateStr=2025-07-04, revisedDate=1755964800000, revisedDateStr=2025-08-24, acceptedDate=null, acceptedDateStr=null, onlineDate=1793961048764, onlineDateStr=2026-11-06, pubDate=1764000000000, pubDateStr=2025-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793961048764, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793961048764, creator=13701087609, updateTime=1793961048764, updator=13701087609, issue=Issue{id=1325531848021140417, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='11', pageStart='1521', pageEnd='1672', issueExtLink='null', onlineDate='null', pubDate='1764000000000', pubDateStr='2025-11-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793961019759, creator='13701087609', updateTime=1793961019759, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1653, endPage=1657, ext={EN=ArticleExt(id=1325531972654882849, articleId=1325531969676927008, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Association between elevated blood pressure and increased pulse wave velocity in adolescents, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between blood pressure levels and brachial-ankle pulse wave velocity (baPWV) in adolescents, so as to provide a scientific basis for early prevention and control of cardiovascular disease.

Methods

The study utilized data from the October to December 2023 survey conducted by of the Huantai Child Cardiovascular Health Cohort, which included 1 197 adolescents aged 12-17 years. According to the Reference of Screening for Elevated Blood Pressure among Children and Adolescents aged 7-18 years, participants were classified into normal, high-normal, and elevated blood pressure groups. The baPWV elevation was defined as a baPWV value greater than or equal to the 90th percentile of the sex- and age-specific baPWV values in the study population. The association between elevated blood pressure and increased baPWV was assessed by binary Logistic regression models. Restricted cubic spline model was applied to evaluate the dose-response curve of the relationship between blood pressure Z-scores and increased baPWV.

Results

Among adolescents, the prevalence of high-normal and elevated blood pressure were 22.6% and 14.1%, respectively. The mean baPWV values were 918, 978 and 1 030 cm/s in the normal, high-normal, and elevated blood pressure groups, respectively. The prevalence rates of elevated baPWV were 7.3%, 9.6% and 27.2% in these three groups correspondingly. Logistic regression analysis showed that, after adjusting for covariates, both high-normal and elevated blood pressure were significantly associated with higher odds of increased baPWV[OR(95%CI)=1.87(1.08-3.20) and 8.24(4.73-14.50), both P < 0.05]. Linear dose-response associations were identified between systolic and diastolic blood pressure Z-scores and increased baPWV (Pnon-linearity>0.05).

Conclusions

Elevated blood pressure in adolescents is positively associated with high baPWV. Greater emphasis should therefore be placed on blood pressure monitoring and health management during adolescence.

, authors=Xiao ZHANG1, Yuedong WANG1, Min ZHAO2, Lili YANG*, 1, Bo XI*, 1, authorsList=Xiao ZHANG, Yuedong WANG, Min ZHAO, Lili YANG, Bo XI, authorCompany=null, correspAuthors=Lili YANG, Bo XI, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325531986873573413, articleId=1325531969676927008, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=青少年血压偏高与脉搏波传导速度升高的关联, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

探讨青少年血压水平与臂踝脉搏波传导速度(baPWV)的关联，为心血管病的早期防控提供科学依据。

方法

研究数据来自“桓台儿童心血管健康随访队列”2023年10—12月开展的调查，共纳入1 197名12~17岁青少年。采用《7岁~18岁儿童青少年血压偏高筛查界值》将青少年血压水平划分为正常血压、正常高值血压和血压偏高三类，将baPWV≥性别、年龄别baPWV值的第90百分位数定义为baPWV升高。采用二元Logistic回归模型探讨血压偏高与青少年baPWV升高的关联，通过限制性立方样条模型拟合血压Z评分与baPWV升高之间的剂量-反应曲线。

结果

青少年正常高值血压和血压偏高的检出率分别为22.6%和14.1%。正常血压组、正常高值血压组及血压偏高组的baPWV水平分别为918，978和1 030 cm/s，baPWV升高检出率分别为7.3%，9.6%和27.2%。Logistic回归分析结果显示，调整协变量后，正常高值血压组和血压偏高组出现baPWV升高的风险均增加[OR值(95%CI)分别为1.87(1.08~3.20)和8.24(4.73~14.50)，P值均＜0.05]。收缩压和舒张压Z评分均与baPWV升高之间存在线性剂量-反应关系(P非线性值>0.05)。

结论

青少年血压偏高与baPWV升高呈正相关，需重视青少年阶段的血压监测与健康管理。

, authors=张霄1, 王悦栋1, 赵敏2, 杨丽丽*, 1, 席波*, 1, authorsList=张霄, 王悦栋, 赵敏, 杨丽丽, 席波, authorCompany=null, correspAuthors=杨丽丽, 席波, authorNote=

张霄(2001-)，女，山东青岛人，在读硕士，主要研究方向为儿童心血管流行病学

, correspAuthorsNote=
杨丽丽，E-mail:
席波，E-mail:
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tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, language=CN, orderNo=2, keyword=脉搏波传导速度), Keyword(id=1325532027084365899, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, language=CN, orderNo=3, keyword=回归分析), Keyword(id=1325532027545739340, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, language=CN, orderNo=4, keyword=青少年)], refs=[Reference(id=1325532043874164820, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=null, journalName=null, refType=null, unstructuredReference=国家心血管病中心, 中国心血管健康与疾病报告编写组, 胡盛寿. 中国心血管健康与疾病报告2023概要[J]. 中国循环杂志, 2024, 39(7): 625-660., articleTitle=null, refAbstract=null), Reference(id=1325532043999993941, tenantId=1146029695717560320, 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Comparison of baseline characteristics distribution of participants across different blood pressure levels

, figureFileSmall=null, figureFileBig=null, tableContent=
组别人数性别体力活动/(h·d-1)每天蔬果摄入频率/次每周碳酸饮料摄入频率/次BMI
男女＜1≥1＜5≥5＜1≥1非超重肥胖超重肥胖
正常血压757290(38.3)467(61.7)568(75.0)189(25.0)563(74.4)194(25.6)606(80.1)151(19.9)553(73.0)121(16.0)83(11.0)
正常高值血压271216(79.7)55(20.3)181(66.8)90(33.2)200(73.8)71(26.2)203(74.9)68(25.1)128(47.2)60(22.2)83(30.6)
血压偏高169113(66.9)56(33.1)114(67.5)55(32.5)128(75.7)41(24.3)136(80.5)33(19.5)29(17.1)42(24.9)98(58.0)
总体1 197619(51.7)578(48.3)863(72.1)334(27.9)891(74.4)306(25.6)945(78.9)252(21.1)710(59.3)223(18.6)264(22.1)
χ2值155.048.850.213.45239.72
P值＜0.010.010.900.18＜0.01
), ArticleFig(id=1325532034223071312, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, language=CN, label=表1, caption=

不同血压水平研究对象基本特征分布比较

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组别人数性别体力活动/(h·d-1)每天蔬果摄入频率/次每周碳酸饮料摄入频率/次BMI
男女＜1≥1＜5≥5＜1≥1非超重肥胖超重肥胖
正常血压757290(38.3)467(61.7)568(75.0)189(25.0)563(74.4)194(25.6)606(80.1)151(19.9)553(73.0)121(16.0)83(11.0)
正常高值血压271216(79.7)55(20.3)181(66.8)90(33.2)200(73.8)71(26.2)203(74.9)68(25.1)128(47.2)60(22.2)83(30.6)
血压偏高169113(66.9)56(33.1)114(67.5)55(32.5)128(75.7)41(24.3)136(80.5)33(19.5)29(17.1)42(24.9)98(58.0)
总体1 197619(51.7)578(48.3)863(72.1)334(27.9)891(74.4)306(25.6)945(78.9)252(21.1)710(59.3)223(18.6)264(22.1)
χ2值155.048.850.213.45239.72
P值＜0.010.010.900.18＜0.01
), ArticleFig(id=1325532034676056145, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, language=EN, label=Tab.2, caption=

Logistic regression analysis of high blood pressure and high baPWV among adolescents of different genders

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性别血压分组模型1模型2模型3
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
男生正常血压组1.001.001.00
(n=619)正常高值血压组1.56(0.61~3.49)0.311.57(0.61~3.53)0.311.83(0.70~4.28)0.19
血压偏高组3.58(1.75~7.02)＜0.013.79(1.84~7.52)＜0.014.91(2.07~11.60)＜0.01
女生正常血压组1.001.001.00
(n=578)正常高值血压组1.79(0.89~3.68)0.111.80(0.89~3.71)0.112.26(1.10~4.75)0.03
血压偏高组7.31(3.83~14.60)＜0.017.47(3.88~15.00)＜0.0113.60(6.22~31.30)＜0.01
总体正常血压1.001.001.00
(n=1 197)正常高值血压组1.54(0.90~2.57)0.111.55(0.91~2.60)0.101.87(1.08~3.20)0.02
血压偏高组5.23(3.31~8.28)＜0.015.31(3.35~8.42)＜0.018.24(4.73~14.50)＜0.01
), ArticleFig(id=1325532036366360658, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325531969676927008, language=CN, label=表2, caption=

不同性别青少年血压偏高与baPWV升高的Logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
性别血压分组模型1模型2模型3
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
男生正常血压组1.001.001.00
(n=619)正常高值血压组1.56(0.61~3.49)0.311.57(0.61~3.53)0.311.83(0.70~4.28)0.19
血压偏高组3.58(1.75~7.02)＜0.013.79(1.84~7.52)＜0.014.91(2.07~11.60)＜0.01
女生正常血压组1.001.001.00
(n=578)正常高值血压组1.79(0.89~3.68)0.111.80(0.89~3.71)0.112.26(1.10~4.75)0.03
血压偏高组7.31(3.83~14.60)＜0.017.47(3.88~15.00)＜0.0113.60(6.22~31.30)＜0.01
总体正常血压1.001.001.00
(n=1 197)正常高值血压组1.54(0.90~2.57)0.111.55(0.91~2.60)0.101.87(1.08~3.20)0.02
血压偏高组5.23(3.31~8.28)＜0.015.31(3.35~8.42)＜0.018.24(4.73~14.50)＜0.01
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青少年血压偏高与脉搏波传导速度升高的关联
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张霄 1 , 王悦栋 1 , 赵敏 2 , 杨丽丽 *, 1 , 席波 *, 1
中国学校卫生 | 疾病控制 2025,46(11): 1653-1657
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中国学校卫生 |疾病控制 2025 , 46 (11) : 1653 -1657
青少年血压偏高与脉搏波传导速度升高的关联
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张霄1, 王悦栋1, 赵敏2, 杨丽丽*, 1 , 席波*, 1
作者信息
  • 1山东大学齐鲁医学院公共卫生学院流行病学系/山东大学儿童心血管研究中心，济南 250012
  • 2山东大学齐鲁医学院公共卫生学院营养与食品卫生学系
通讯作者:
杨丽丽，E-mail:
席波，E-mail:
作者简介:

张霄(2001-)，女，山东青岛人，在读硕士，主要研究方向为儿童心血管流行病学

Association between elevated blood pressure and increased pulse wave velocity in adolescents
Xiao ZHANG1, Yuedong WANG1, Min ZHAO2, Lili YANG*, 1 , Bo XI*, 1
Affiliations
  • 1Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Jinan 250012, Shandong Province, China
出版时间: 2025-11-25 doi: 10.16835/j.cnki.1000-9817.2025324
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摘要
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目的

探讨青少年血压水平与臂踝脉搏波传导速度(baPWV)的关联，为心血管病的早期防控提供科学依据。

方法

研究数据来自“桓台儿童心血管健康随访队列”2023年10—12月开展的调查，共纳入1 197名12~17岁青少年。采用《7岁~18岁儿童青少年血压偏高筛查界值》将青少年血压水平划分为正常血压、正常高值血压和血压偏高三类，将baPWV≥性别、年龄别baPWV值的第90百分位数定义为baPWV升高。采用二元Logistic回归模型探讨血压偏高与青少年baPWV升高的关联，通过限制性立方样条模型拟合血压Z评分与baPWV升高之间的剂量-反应曲线。

结果

青少年正常高值血压和血压偏高的检出率分别为22.6%和14.1%。正常血压组、正常高值血压组及血压偏高组的baPWV水平分别为918，978和1 030 cm/s，baPWV升高检出率分别为7.3%，9.6%和27.2%。Logistic回归分析结果显示，调整协变量后，正常高值血压组和血压偏高组出现baPWV升高的风险均增加[OR值(95%CI)分别为1.87(1.08~3.20)和8.24(4.73~14.50)，P值均＜0.05]。收缩压和舒张压Z评分均与baPWV升高之间存在线性剂量-反应关系(P非线性值>0.05)。

结论

青少年血压偏高与baPWV升高呈正相关，需重视青少年阶段的血压监测与健康管理。

血压  /  脉搏波传导速度  /  回归分析  /  青少年
Objective

To explore the association between blood pressure levels and brachial-ankle pulse wave velocity (baPWV) in adolescents, so as to provide a scientific basis for early prevention and control of cardiovascular disease.

Methods

The study utilized data from the October to December 2023 survey conducted by of the Huantai Child Cardiovascular Health Cohort, which included 1 197 adolescents aged 12-17 years. According to the Reference of Screening for Elevated Blood Pressure among Children and Adolescents aged 7-18 years, participants were classified into normal, high-normal, and elevated blood pressure groups. The baPWV elevation was defined as a baPWV value greater than or equal to the 90th percentile of the sex- and age-specific baPWV values in the study population. The association between elevated blood pressure and increased baPWV was assessed by binary Logistic regression models. Restricted cubic spline model was applied to evaluate the dose-response curve of the relationship between blood pressure Z-scores and increased baPWV.

Results

Among adolescents, the prevalence of high-normal and elevated blood pressure were 22.6% and 14.1%, respectively. The mean baPWV values were 918, 978 and 1 030 cm/s in the normal, high-normal, and elevated blood pressure groups, respectively. The prevalence rates of elevated baPWV were 7.3%, 9.6% and 27.2% in these three groups correspondingly. Logistic regression analysis showed that, after adjusting for covariates, both high-normal and elevated blood pressure were significantly associated with higher odds of increased baPWV[OR(95%CI)=1.87(1.08-3.20) and 8.24(4.73-14.50), both P < 0.05]. Linear dose-response associations were identified between systolic and diastolic blood pressure Z-scores and increased baPWV (Pnon-linearity>0.05).

Conclusions

Elevated blood pressure in adolescents is positively associated with high baPWV. Greater emphasis should therefore be placed on blood pressure monitoring and health management during adolescence.

Blood pressure  /  Brachial-ankle pulse wave velocity  /  Regression analysis  /  Adolescent
张霄, 王悦栋, 赵敏, 杨丽丽, 席波. 青少年血压偏高与脉搏波传导速度升高的关联. 中国学校卫生, 2025 , 46 (11) : 1653 -1657 . DOI: 10.16835/j.cnki.1000-9817.2025324
Xiao ZHANG, Yuedong WANG, Min ZHAO, Lili YANG, Bo XI. Association between elevated blood pressure and increased pulse wave velocity in adolescents[J]. Chinese Journal of School Health, 2025 , 46 (11) : 1653 -1657 . DOI: 10.16835/j.cnki.1000-9817.2025324
正文
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据《中国心血管健康与疾病报告2023》显示，我国心血管疾病患病率和死亡率持续上升，目前患者总数已达3.3亿，每5例死亡病例中便有2例可归因于心血管疾病[1]。越来越多研究证据表明心血管疾病的发生和发展可追溯至儿童青少年时期[2]。例如，有研究发现部分儿童青少年已出现早期动脉硬化，表现为臂踝脉搏波传导速度(brachial-ankle pulse wave velocity, baPWV)升高[3]。baPWV升高已被证实可独立预测成年后心血管事件和死亡发生风险[4]。因此，识别儿童青少年baPWV升高的危险因素并早期干预，对缓解我国心血管疾病负担具有重要意义。
成人研究显示高血压是baPWV升高的重要危险因素[5]。然而，关于青少年血压水平与baPWV之间关联的研究仍相对有限[6]。同时，随着我国青少年肥胖的流行，青少年血压偏高检出率呈快速上升趋势[7]。本研究基于“桓台儿童心血管健康随访队列”数据，旨在探讨青少年血压水平与baPWV的关联，为心血管疾病早期防控提供理论支持。
1　对象与方法
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1.1　对象
研究采用横断面研究设计，数据来源于“桓台儿童心血管健康随访队列”[8]2023年10—12月开展的调查，共1 200名12~17岁青少年参与。排除部分变量缺失者后，共纳入1 197名青少年。其中男生619名，女生578名，平均年龄(14.1±1.5)岁。研究方案经山东大学公共卫生伦理学委员会的批准(批号：20160308)，所有参与对象及其家长/监护人均知情同意并签署书面文件。
1.2　方法
1.2.1　血压测量
采用经验证的欧姆龙HEM-1300电子血压计测量血压。要求受试者测量前30 min内禁止剧烈运动，静坐休息5 min以上，双脚平放地面，连续测量3次，2次测量值之间误差不超过10 mmHg(1 mmHg=0.133 kPa)；取后2次测量的平均值作为最终血压值。若误差超过10 mmHg，则需要受试者静坐5 min后再次重新测量。
1.2.2　baPWV检查
使用欧姆龙BP-203RPEⅢ动脉硬化检测仪完成测量。测量时受试者取仰卧位，双上肢自然置于体侧。依次安装脚踝袖带(对准踝骨中心)、上臂袖带(距肘窝1~2指)、心音夹(贴紧手腕内侧)和心音传感器(置于第三肋正中)。仪器可自动计算左右侧baPWV，取平均值用于分析。
1.2.3　协变量
采用自编问卷收集青少年的年龄、性别、每日睡眠时长、电子屏幕使用时长、体力活动及饮食情况(如蔬果和碳酸饮料摄入)等。身高和体重使用HGM-300身高体重仪测量，测量时受试者穿着轻便衣服，双手自然下垂，平视前方。连续测量2次，身高精确至0.1 cm，体重精确至0.1 kg，取平均值用于计算体质量指数(body mass index, BMI)，BMI=体重(kg)/[身高(m)]2。
1.3　变量定义
1.3.1　正常高值血压和血压偏高
血压分类参照《7岁~18岁儿童青少年血压偏高筛查界值》(WS/T 610—2018)[9]，将收缩压和/或舒张压低于同性别、同年龄及同身高组别血压分布的第90百分位数定义为正常血压；介于第90百分位数(或120/80 mmHg)与第95百分位数之间为正常高值血压；大于或等于第95百分位数为血压偏高。
1.3.2　baPWV升高
参考既往文献[3]，将该人群青少年性别、年龄别baPWV分布的第90百分位数作为界值，baPWV值大于或等于该界值定义为baPWV升高。
1.3.3　协变量
以《学龄儿童青少年超重与肥胖筛查》(WS/T 586—2018)标准定义非超重肥胖、超重和肥胖[10]。每日睡眠时长为通常晚上睡觉和早上起床的时间差[11]；每日视屏时间为日均电子设备屏幕使用时长[12]；体力活动按每日中高强度运动时长分为＜1 h/d(不足)和≥1 h/d(充足)[13]；蔬果摄入为近30 d每日蔬菜水果食用频次之和，分为＜5和≥5次/d[14]；碳酸饮料摄入为近30 d每周摄入碳酸饮料的情况，分为＜1和≥1次[15]。
1.4　质量控制
调查前对调查人员进行统一培训，明确分工并规范操作流程。问卷发放前详细告知填写规范，回收后由专业人员实施质控审核。随机选取13名参与者在间隔1周后进行问卷重测，结果显示重测信度较高，膳食相关条目的Kappa值均大于0.80。测量前统一校准电子血压计，全程采用同型号设备进行数据采集。测量baPWV时，严格按照操作规范依次安装袖带、心音夹和传感器；每次测量前检查心电图波形和心音图信号是否达标，每测量2~3人更换一次凝胶贴，以确保信号传导质量。调查结束后，使用EpiData 3.0软件进行双人独立录入。数据录入完成后比对双份录入结果，发现不一致之处即查阅原始问卷进行核查并修正。
1.5　统计学分析
利用R 4.3.1软件完成统计分析。分类变量以频数(构成比)表示，组间比较采用χ2检验。连续变量经Shapiro-Wilk检验后，对不符合正态分布的数据用M(P25，P75)进行描述，组间比较采用Kruskal-Wallis秩和检验。通过Logistic回归模型分析血压偏高与baPWV升高的关联，校正变量包括年龄、性别、碳酸饮料摄入频率、蔬果摄入频率、体力活动、每日睡眠时长、每日视屏时间及BMI。按性别分层后进行亚组分析。基于性别和年龄计算收缩压和舒张压Z评分[16-18]，采用限制性立方样条(restricted cubic spline, RCS)模型分析收缩压和舒张压Z评分与baPWV升高之间的剂量-反应关系。检验水准α=0.05。
2　结果
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2.1　青少年血压情况
青少年中正常高值血压检出率为22.6%，血压偏高检出率为14.1%。不同血压水平组中性别、体力活动和营养状况分布差异均有统计学意义(P值均＜0.05)。见表1。正常血压、正常高值血压和血压偏高组年龄分别为14.0(13.0, 15.0)、15.0(13.0, 16.0)、15.0(13.0, 15.0)岁，每日睡眠时长分别为7.4(6.8, 8.0)、7.3(6.7, 8.0)、7.2(6.5, 7.8)h，组间差异均有统计学意义(H值分别为10.54，7.31，P值均＜0.05)。
2.2　不同血压水平青少年baPWV及其升高的检出率
正常血压组、正常高值血压组及血压偏高组的baPWV水平分别为918，978和1 030 cm/s，男生分别为929, 982，1 048 cm/s，女生分别为911，960，992 cm/s。各组baPWV升高检出率逐渐上升，总体依次为7.3%(55名)，9.6%(26名)和27.2%(46名)，男生依次为5.2%(15名)，8.8%(19名)，28.3%(32名)，女生依次为8.6%(40名)，12.7%(7名)，25.0%(14名)。
2.3　青少年血压偏高与baPWV升高的关联
校正相关协变量后，与正常血压组相比，正常高值血压组和血压偏高组出现baPWV升高的风险均增加(P值均＜0.05)。按照性别分层得到类似的结果，且在女生中血压偏高组出现baPWV升高的风险高于男生。见表2。
2.4　青少年血压偏高与baPWV升高的剂量-反应关系
经RCS分析(调整相关协变量后)，收缩压与舒张压Z评分均显示与baPWV升高呈线性剂量-反应关系(P非线性值均>0.05)，见图1。
3　讨论
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本研究结果显示，与正常血压的青少年相比，正常高值血压和血压偏高青少年出现baPWV升高的风险增加，且女生风险高于男生。RCS分析显示血压水平与baPWV升高呈线性剂量-反应关系。
目前关于儿童青少年血压与baPWV关联的研究证据有限，但均支持本研究结论。如Im等[19]在韩国开展一项横断面研究，招募了262名青少年，发现血压偏高青少年较正常血压者baPWV水平增高。一项在中国北京开展的队列研究纳入80名高血压儿童和158名正常血压儿童，随访2年后结果显示，与正常血压组相比，持续高血压组发生baPWV升高风险增加[20]。汉中儿童青少年高血压队列研究显示血压变化与baPWV进展密切相关[21]。因此，儿童青少年时期开展血压监测有助于早期识别高风险人群，为预防未来心血管疾病提供干预契机。
目前关于儿童青少年血压偏高与baPWV升高关联的病理生理机制尚不完全明晰。血压升高使大动脉血管壁承受的机械负荷(包括周向张力和剪切应力)显著增加[22]。长期机械负荷可引发内皮功能障碍，表现为氧化应激增加、慢性低度炎症增强及内皮屏障功能受损，最终导致血管壁结构重塑(如内膜增厚，早期可能伴脂质沉积)，降低血管顺应性并加速动脉硬化进程[23]。青春期女生动脉顺应性基线水平普遍低于同龄男生，脉压显著升高，血压升高对血管的损伤更易发生[24]。值得注意的是，此类性别差异与肥胖密切关联，青春期肥胖女生常表现为内脏脂肪堆积明显和脂联素水平降低，进一步促进baPWV升高及动脉硬化加速进展[25]。
本研究在较大样本基础上评估了青少年血压偏高与baPWV升高的相关性，但仍存在局限：首先，横断面设计难以确定血压偏高与baPWV升高的时序关系；其次，数据来源于山东省桓台县的在校生，结果外推需谨慎；最后，女生血压偏高组样本量有限，导致效应量的估计不够精确，需更大规模研究加以验证。
综上所述，青少年血压偏高与baPWV升高呈正相关，且该关联在女生中更为显著。鉴于我国青少年血压偏高的流行形势日益严峻，及早识别并干预血压偏高对于促进心血管健康具有重要公共卫生意义。
基金
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  • 国家自然科学基金项目(82173538，82473653)；中国博士后科学基金项目(2023M742061)；山东省博士后创新人才支持计划项目(SDBX2023003)
文献
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2025年第46卷第11期
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doi: 10.16835/j.cnki.1000-9817.2025324
  • 接收时间：2025-07-04
  • 首发时间：2026-11-06
  • 出版时间：2025-11-25
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  • 收稿日期：2025-07-04
  • 修回日期：2025-08-24
基金
国家自然科学基金项目(82173538，82473653)；中国博士后科学基金项目(2023M742061)；山东省博士后创新人才支持计划项目(SDBX2023003)
作者信息
    1山东大学齐鲁医学院公共卫生学院流行病学系/山东大学儿童心血管研究中心，济南 250012
    2山东大学齐鲁医学院公共卫生学院营养与食品卫生学系

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