[01] Ypertasika to 30% twn paxysarkwn paidiwn

Opws ejhgei o k. Roysso, safhs genetikh epidrash yparxei mono se merika spania syndroma. Sthn pleionothta twn periptwsewn fainetai oti ayto poy klhronomeitai einai h tash gia paxysarkia. Otan ta genetika prodiateqeimena atoma breqoyn se katallhlo periballon, opws einai h kaqistikh zwh, h ploysia se liph kai qermides diatrofh, h elattwmenh fysikh drasthriothta, to dysmenes koinwnikoikonomiko periballon kai alla polla, tote qa emfanisoyn paxysarkia.

O k. Roysso epishmainei oti to problhma me thn paidikh paxysarkia einai ditto. Prwton giati h paxysarkia exei thn tash na epimenei kai kata thn enhliko zwh kai deyteron dioti syndeetai amesa me thn ayjhsh ths noshrothtas. Exei breqei oti ena paxysarko paidi hlikias 2-3 etwn exei diplasies piqanothtes na ginei kai paxysarkos enhlikas ap'o,ti ena mh paxysarko. Oi piqanothtes aytes ejaplasiazontai otan prokeitai gia paxysarkoys efhboys. Ayto shmainei oti to 70-80% peripoy twn paidiwn poy einai paxysarka sthn hlikia 12-13 etwn qa parameinoyn etsi kai sthn ypoloipoi zwh.

To deytero megalo problhma me thn paidikh paxysarkia einai oti mporei na balei tis baseis gia mia seira ekfylistikwn noshmatwn, ta opoia an kai tis perissoteres fores qa ekdhlwqoyn argotera kata thn enhliko zwh, tipota den apokleiei thn emfanish toys kai kata thn paidikh hlikia. H ypertash, h ayjhsh twn epipedwn ths xolhsterolhs, twn triglykeridiwn, ths xamhlhs pyknothtas lipoprwteinwn, o ypoaerismos twn pneymonwn kai oi apnoies kata th diarkeia toy ypnoy, ta orqopedika problhmata, h prwimh hbh, o yperinsoylinismos kai sakxarwdhs diabhths typoy II einai poly pio syxna sta paxysarka paidia.

Dedomenoy oti h paxysarkia toy enhlika einai sxedon aniath h prospaqeia antimetwpishs ths barias ayths metabolikhs nosoy qa prepei na arxisei to dynato nwritera kai na basistei sto triptyxo: swsth diatrofh, askhsh, cyxologikh yposthrijh. H diatrofh poy qa systhqei prepei na ejasfalizei to paidi fysiologikh ayjhsh kai anaptyjh. Oi aysthres diaites kai apagoreyseis den exoyn kamia qesh. Ola epitrepontai me metro, enw stoxos einai h staqeropoihsh toy baroys mexri h analogia baroys pros ycos na epanelqei se fysiologika epipeda, enw stis periptwseis ekeines poy h meiwsh toy baroys krinetai aparaithth ayth den prepei na jeperna to 1-2 kila to mhna.

Ypertash sto 30% twn paxysarkwn paidiwn To endiaferon twn eidikwn gia thn paidikh ypertash exei ayjhqei ta teleytaia xronia. Oi logoi poy odhghsan se ayto einai h ayjhsh ths syxnothtas ths, o amesos sysxetismos ths me thn ypertash sthn enhliko zwh kai to gegonos oti epace na qewreitai pleon ``siwphrh'' nosos, afoy odhgei syxna se ypertrofia ths aristerhs koilias, katastash poy aneyrisketai sto 41% twn paidiwn me ypertash, kai se anaptyjh aqhrwmatikwn aggeiakwn blabwn. Ayta epishmainei h epimelhtria B'ESY sthn B' Paidiatrikh Panepisthmiakh Klinikh toy nosokomeioy AXEPA Maria Stamoy.

Enw to 1999 se metrhsh roytinas ths arthriakhs pieshs se 15.000 paidia to pososto ths ypertashs se ayta htan 1,1%, antistoixh meleth to 2002 anebase to pososto se 4,5%. H ayjhsh ayth afora thn idiopaqh ypertash, parathreitai kyriws sta paidia meta thn hlikia twn 10 etwn kai ofeiletai kata kyrio logo sthn epidhmikh epelash ths paidikhs paxysarkias kai thn allagh toy tropoy zwhs kai diatrofhs twn paidiwn. H ayjhsh toy deikth mazas swmatos sxetizetai amesa me thn ypertash, kaqws ayth anixneyetai se pososto panw apo 30% twn paxysarkwn paidiwn. Opws anaferei h k Stamoy, ypertash poy sxetizetai me thn paxysarkia parathrhqhke akomh kai se paidia hlikias 2 kai 5 etwn. Ta paidia me sobarh ypertash mporei na emfanisoyn eikona ypertasikhs egkefalopaqeias, spasmoys, egkefalika epeisodia kai symforhtikh kardiopaqeia.

Ektos apo thn paxysarkia paragontes ths paidikhs ypertashs einai to oikogeneiako istoriko ypertashs, diabhth kai kardiaggeiakwn paqhsewn. Meleth edeije oti paidia me idiopaqh ypertash eixan toylaxiston ena syggenh me idiopaqh ypertash se pososto 49%. H piqanothta ayth se paidia me deyteropaqh ypertash htan antistoixa 46%. Synolika, efhboi me ypertash exoyn qetiko oikogeneiako istoriko se pososto 86%.

H deyteropaqhs ypertash einai pio syxnh se paidia se sxesh me toy enhlikes. Idiaitera se paidia proefhbikhs hlikias katw twn 10 xronwn prepei na apokleietai h piqanothta ypokeimenhs nosoy. H pio syxnh ypokeimenh nosos afora ta nefra se pososto 60-70%, enw alles aities einai oi nosoi twn endokrinwn adenwn, stenwsh isqmoy aorths kai ypertash poy ofeiletai se iatrogeneis aities (farmaka). Epibaryntikoi paragontes gia deyteropaqh ypertash einai h barythta ths ypertashs, h mikrh hlikia kai h jafnikh ayjhsh ths arthriakhs pieshs se adynato paidi me eleyqero oikogeneiako istoriko gia diabhth, ypertash h paxysarkia. Antiqeta, oi efhboi exoyn idiopaqh ypertash se pososto 85-95% twn periptwsewn. Ajiologoi prodiaqesikoi paragontes idiopaqoys ypertashs ektos toy qetikoy oikogeneiakoy istorikoy kai ths paxysarkias einai o syndyasmos parametrwn poy prosdiorizoyn thn yparjh metabolikoy syndromoy to opoio anixneyetai se pososto 4,2-8,4% twn efhbwn.

Symfwna me thn k. Stamoy ena paidi exei fysiologikh arthriakh piesh otan h timh ths einai katw apo thn 90h ekatostiaia qesh gia thn hlikia, to fylo kai to ycos. Ychlh mesa se fysiologika oria einai otan h timh ths einai panw apo thn 90h kai katw apo thn 95h ekatostiaia qesh, enw ypertasiko xarakthrizetai ena paidi poy h arthriakh toy piesh einai panw apo thn 95h ekatostiaia qesh.

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