不同血压水平状态下的中心动脉压与诊室肱动脉血压  

Comparison of central arterial pressure and brachial artery blood pressure in different blood pressure levels

作　　者：王欢[1] 刘海明[1] 梁晓慧[1] 张俊仕[1] 徐新娟[1] 

机构地区：[1]新疆医科大学第一附属医院高血压科,新疆乌鲁木齐830054

出　　处：《中华高血压杂志》2017年第11期1061-1066,共6页Chinese Journal of Hypertension

摘　　要：目的比较不同血压水平状态下中心动脉压(CAP)与诊室肱动脉血压的差异。方法连续性选取2012年1月至2016年1月就诊于新疆医科大学第一附属医院的原发性高血压患者2647例,另选取同时期在新疆医科大学第一附属医院体检的正常血压者972人。两组研究对象均进行一般情况调查、测定诊室肱动脉血压及无创CAP,比较不同血压水平状态下CAP与诊室肱动脉血压的差异。结果 CAP与诊室血压比较,正常血压组收缩压差值为(12.30±5.00)mm Hg,95%CI为2.50~22.10 mm Hg;舒张压差值为(-1.65±2.12)mm Hg,95%CI为-5.81~2.51mm Hg;脉压差值为(13.97±5.35)mm Hg,95%CI为3.48~24.46mm Hg。高血压组收缩压差值为(13.40±14.19)mm Hg,95%CI为-14.41~40.79mm Hg;舒张压差值为(-1.19±11.87)mm Hg,95%CI为-24.46~22.08mm Hg;脉压差值为(14.52±19.85)mm Hg,95%CI为-24.39~53.40mm Hg。高血压组与正常血压组,中心动脉收缩压(CASP)、中心动脉舒张压(CADP)、中心动脉脉压均随着对应诊室收缩压(OSP)、诊室舒张压(ODP)、诊室脉压的升高而升高(P<0.01)。受试者工作特征(ROC)曲线示,对于高血压组1级的诊断,OSP与CASP的曲线下面积分别为0.994(95%CI0.992~0.995)和0.982(0.978~0.986);ODP与CADP的曲线下面积分别为0.925(0.917~0.934)和0.914(0.905~0.923)。若以CAP对高血压进行分级,本研究人群CAP 1,2,3级水平分别为123.5/82.5mm Hg(约登指数=0.869,0.678),136.5/96.5(约登指数=0.323,0.750)和155.5/106.5mm Hg(约登指数=0.553,0.654)。结论 CAP与诊室血压的一致性较好,舒张压的一致性好于收缩压、脉压的一致性。诊室血压仍可作为诊断高血压的较为简便、实用、广泛的方法。Objective To compare the difference between central arterial pressure （CAP） and brachial artery blood pressure in different blood pressure levels. Methods A total of 2647 hypertensives and 972 normotensives between January 2012 and January 2016 in the First Affiliated Hospital of Xinjiang Medical University were enrolled. The clinical data were investigated. The brachial artery blood pressure and CAP were measured and compared. Results In normotensives, the difference of systolic CAP and brachial artery blood pressure was （12.30：k 5.00, 95% CI 2.50-22.10} mm Hg; the difference of diastolic pressure was （ --1.65±2.12, 95% CI --5.81 to 2.51） mm Hg; the difference of pulse pressure was （13.97± 5.35,95 % CI 3.48--24. 46） mm Hg. In hypertensives, the difference of systolic pressure was （13.40±14.19, 95% CI -14.41 to 40.79） mm Hg; the difference of diastolic pres- sure was （-- 1.19 ± 11.87, 95% CI -- 24.46 to 22.08） mm Hg; the difference of pulse pressure was （14.52 ：J： 19.85, 95% CI -24.39 to 53.40） mm Hg. In hypertensives and normotensives, the central arterial systolic pres- sure （CASP）, central arterial diastolic blood pressure （CADP） and central arterial pulse pressure （CAPP） rised with corresponding office systolic pressure（OSP}, office diastolic blood（ODP} and office pulse pressure, respectively （P〈0.01）. According to receiver operating characteristic（ROC） curve, areas under the curve of OSP and CASP were 0. 994 （95〈 CI 0. 992-0. 995） and 0. 982（0. 978--0. 986） respectively; and the areas of ODP and CADP were 0. 925（0. 917--0. 934） and 0. 914（0. 905-0. 923） respectively for the diagnosis of grade 1 hypertension. The cut-off value of CAP for the diagnosis of grade 1, 2, 3 hypertension was 123.5/82.5 mm Hg （Youden index = 0.869, 0.678）, 136.5/96.5（Youden index=0.323,0.750） and 155.5/106.5 mm Hg （Youden index=0.553, 0. 654）, respectively. Conclusion CAP is consistent with braehial artery blood pressure, and the consistency o

关 键 词：中心动脉压 诊室肱动脉压 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]