臂围与血压计袖带匹配对血压准确测量的重要性  

The Impact of Cuff Size on Accuracy of Blood Pressure Readings

作　　者：陈继升[1,2] 吴延庆[1] 程晓曙[1] 苏海[1] 李颐[1] 许美珍[1] 章倩[1] 

机构地区：[1]南昌大学第二附属医院心内科,江西南昌330006 [2]临安市人民医院心内科

出　　处：《中华高血压杂志》2009年第9期806-810,共5页Chinese Journal of Hypertension

基　　金：江西省卫生厅课题基金资助(20071062)

摘　　要：目的探讨臂围袖带匹配对血压准确测量的重要性。方法选取临床需行冠状动脉造影的患者241例,冠状动脉造影前同步测量直接血压和间接血压各3次,取平均值,间接血压分别用普通袖带及理想袖带进行测量,其中臂围<27 cm者(n=75)仅用普通袖带(12 cm×22 cm)测量间接血压;臂围在27～34 cm者(n=156)用中号袖带(13 cm×30 cm)作为"理想"袖带;臂围>34 cm者(n=10)用大号袖带(16 cm×38 cm)作为"理想"袖带。测身高、体质量、臂围、腰围、臀围,计算体质量指数、腰围/臀围、腰围/身高、直间接收缩压差值(S-S)、直间接舒张压差值(D-D)、普通与理想袖带测量的收缩压差值(pS-S)和舒张压差值(pD-D)。结果241例患者臂围均值为(28.3±3.5)cm,68.9%的患者臂围≥27cm。直接血压总体上比普通袖带测量的间接血压要高(P<0.01);普通袖带比"理想"袖带测量的间接血压值要高,且随臂围的增大,其差值越大,臂围在27～34 cm者pS-S、pD-D分别为(3.6±3.1)、(4.5±5.0)mmHg(均P<0.01),臂围>34 cm者pS-S、pD-D分别为(13.5±6.0)、(11.8±5.6)mmHg(均P<0.01)。臂围≥27 cm时用普通袖带较用"理想"袖带测量血压发生假性高血压的比例明显增高,其中舒张性假性高血压为27.1%比4.8%,收缩性假性高血压为13.3%比1.8%,均P<0.01;臂围<27 cm者与臂围27～34 cm者分别用相匹配的"理想"袖带测量血压时,发生假性高血压的比例无明显差异(收缩性假性高血压2.7%比1.9%;舒张性假性高血压5.3%比4.5%,均P>0.05)。结论本研究人群中上臂围周径≥27 cm者达68.9%,应用目前临床普通袖带测量血压会带来误差,用与臂围相匹配的理想袖带测量血压可以减少假性高血压的发生。Objective To explore the influence of cuff size on accuracy of non-invasive measurement of blood pressure （BP） reading. Methods A cohort of 241 patients （155 males and 86 females） average age （61.3±12.2） years were enrolled. Invasive and non-invasive BP were measured before coronary angiography （CAG）. The ordinary cuff and the ＂ideal＂ cuff were used to determine the non-invasive BP. These patients were classified into 3 groups according to their upper arm circumference （UAC）. The non-invasive BP were measured by only ordinary cuff-bladder （12 cm×22 cm） in patients with UAC〈27 cm, the ordinary and the ＂ideal＂ cuff-bladder （13 cm×30 cm） in patients with UAC 27-34 cm, while the ordinary and the ＂ideal＂ cuff-bladder（ 16 cm× 38 cm） in patients with UAC 〉 34 cm, respectively. Body height, body mass, upper arm circumference （AC）, waist circumference （WC）, hip circumference （HC） and body mass index （BMI）, waist hip ratio （WHR）, waist to height ratio, mean BP （MBP） were measured, the difference between invasive BP and non-invasive BP, the difference between non-invasive BP measured with ordinary cuff and that measured with ideal cuff （pS-S, pD-D） were calculated. Results The mean UAC was （28. 3±3.5） cm in this cohort of subjects with 68.9% patients have UAC greater than 27 cm. Invasive BP readings were higher than those by ordinary cuff non-invasive measurement while BP readings were higher by ordinary cuff than those by ＂ideal＂ cuff. The difference was greater with increasing UAC. The pS-S and pD-D were （3.6±3.1）, （4.5±5.0） mmHg in patients with UAC 27-34 cm （P〈0.01）, and （13.5±6.0）, （11.8± 5.6） mmHg in patients with UAC〉34 cm （P〈0.01）, respectively. The prevalence of pseudo-hypertension was higher when BP was measured by ordinary cuff than that by ideal cuff-bladder in patients with UAC≥27 cm,in which diastolic pseudo-hypertension was more prevailing than systolic pseudo-hypertension. Conclusion I

关 键 词：直接血压 间接血压 袖带 臂围 假性高血压 

分 类 号：R544.1[医药卫生—心血管疾病]