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儿童COVID-19合并高血压2例
Coronavirus disease 2019 and hypertension in 2 children
该文报道2例新型冠状病毒肺炎（COVID-19）合并高血压基础疾病患儿的诊疗经过。病例1为13岁3月龄男性患儿，以发热、干咳为主要表现，胸部CT提示左下肺叶磨玻璃影，咽拭子新型冠状病毒（SARS-CoV-2）核酸检测阳性；病例2为13岁8月龄男性患儿，无临床症状，胸部CT无异常，咽拭子SARS-CoV-2核酸检测阳性。两者均为家族聚集性发病，均有高血压家族史，且体质肥胖，住院期间连续多次监测静息状态下血压高于同龄儿童正常值95%参考区间，分别予钙通道阻滞剂及β受体阻滞剂，血压控制可，临床痊愈出院。该文病例提示应重视疫情期间对有高血压等心血管基础疾病的COVID-19患儿的综合管理。
This article reports the diagnosis and treatment of two children with coronavirus disease 2019 (COVID-19) and hypertension. Case 1 was a boy aged 13 years and 3 months, with the main manifestations of fever and dry cough; chest CT showed ground-glass opacities, and the nucleic acid test of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) yielded a positive result. Case 2 was a boy aged 13 years and 8 months and had no clinical symptoms; chest CT showed no abnormality, while the nucleic acid test of SARS-CoV-2 yielded a positive result. Both cases were shown with family aggregation of SARS-CoV-2 infection. They had obesity and a family history of hypertension. Continuous blood pressure monitoring in the resting state during hospitalization showed that blood pressure was above the 95% reference interval of normal value for children of the same age, and the two boys were given calcium channel blockers or β-receptor blockers and were then recovered. It is concluded that comprehensive management of children with COVID-19 and underlying cardiovascular diseases, including hypertension, should be taken seriously during the epidemic.
严重急性呼吸综合征冠状病毒2 / 高血压 / 儿童
Severe acute respiratory syndrome coronavirus 2 / Hypertension / Child
[1] Xu X, Chen P, Wang J, et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission[J]. Sci China Life Sci, 2020, 63(3):457-460.
[2] 侯攀, 徐强, 那剑, 等. 血管紧张素转化酶2与冠状病毒的"不解之缘":感染与致病机制进展[J/OL]. 中华心血管病杂志, 2020. DOI:10.3760/cma.j.cn112148-20200224-00121. 网络预发表.
[3] Te Riet L, van Esch JH, Roks AJ, et al. Hypertension:renin-angiotensin-aldosterone system alterations[J]. Circ Res, 2015, 116(6):960-975.
[4] Patel VB, Zhong JC, Grant MB, et al. Role of the ACE2/angiotensin 1-7 axis of the renin-angiotensin system in heart failure[J]. Circ Res, 2016, 118(8):1313-1326.
[5] 湖北省医学会儿科学分会, 武汉医学会儿科学分会, 湖北省儿科医疗质量控制中心. 湖北省儿童新型冠状病毒感染诊疗建议(试行第一版)[J]. 中国当代儿科杂志, 2020, 22(2):96-99.
[6] 中华预防医学会新型冠状病毒肺炎防控专家组. 新型冠状病毒肺炎流行病学特征的最新认识[J]. 中华流行病学杂志, 2020, 41(2):139-144.
[7] Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China[J]. Pediatrics, 2020. pii:e20200702.
[8] Ahern D, Dixon E. Pediatric hypertension:a growing problem[J]. Prim Care, 2015, 42(1):143-150.
[9] 田杰, 孙慧超. 儿童高血压的临床表现及判断[J]. 中华实用儿科临床杂志, 2015, 30(13):968-971.
[10] Dijkman R, Jebbink MF, Deijs M, et al. Replication-dependent downregulation of cellular angiotensin-converting enzyme 2 protein expression by human coronavirus NL63[J]. J Gen Virol, 2012, 93(Pt 9):1924-1929.
[11] Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure[J]. Nature, 2005, 436(7047):112-116.
[12] Hamming I, Timens W, Bulthuis ML, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis[J]. J Pathol, 2004, 203(2):631-637.
[13] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223):497-506.
[14] Ferrario CM, Jessup J, Chappell MC, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2[J]. Circulation, 2005, 111(20):2605-2610.
[15] Mortensen EM, Pugh MJ, Copeland LA, et al. Impact of statins and angiotensin-converting enzyme inhibitors on mortality of subjects hospitalised with pneumonia[J]. Eur Respir J, 2008, 31(3):611-617.
[16] Ohkubo T, Chapman N, Neal B, et al. Effects of an angiotensin-converting enzyme inhibitor-based regimen on pneumonia risk[J]. Am J Respir Crit Care Med, 2004, 169(9):1041-1055.
