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中心动脉压与外周动脉血压的相关性及一致性研究

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  • R544

摘要:

目的 探讨中心动脉压与外周动脉血压的相关性及一致性。方法 选择2017年12月至2018年
7月于上海市第十人民医院心脏中心就诊的符合纳入排除标准的患者49例,直接测量有创中心动脉收缩
压、有创桡动脉收缩压,同时使用袖带式电子血压计测量无创肱动脉收缩压,使用SphygmoCor仪器测量
无创中心动脉收缩压,分析不同测量方法的一致性和相关性。结果 有创中心动脉收缩压(126.9±19.5
mmHg)显著低于有创桡动脉收缩压(138.9±25.8 mmHg)及无创肱动脉SBP(138.6±17.7 mmHg)(1
mmHg=0.133kPa)(P均<0.001)。推算无创中心动脉收缩压时,采用有创桡动脉压和无创肱动脉压,
与收缩压/舒张压和平均压/舒张压两两组合,共计4种模型。有创中心动脉收缩压与四种方法推算的无创
中心动脉收缩压比较均未见显著性差异(P>0.05),但呈显著正相关(r≥0.622,P<0.001)。Bland-
Altman作图分析显示,使用无创肱动脉压推算出的中心动脉收缩压与有创中心动脉收缩压相比,93.9%
的点在一致性界限以内。ROC曲线分析显示,使用无创肱动脉压推算中心动脉收缩压时,采用收缩压/舒
张压或平均压/舒张压校正,对中心高血压的检测能力无显著性差异(P=0.24)。结论 无创及有创外周
动脉血压均不能真实反映中心动脉血压;无创中心收缩压与有创直接测量值相关性及一致性良好,无创
中心动脉收缩压对中心高血压的诊断具有一定价值。

Abstract:

Objective To study the correlation and consistency between central aortic pressure and peripheral
artery pressure. Methods Forty-nine patients who met the inclusion criteria at the Heart Center of Shanghai Tenth
People's Hospital from December 2017 to July 2018 were selected. Direct measurement of systolic blood pressure
(SBP) and invasive radial artery SBP. At the same time, the cuff electronic sphygmomanometer was used to measure
the noninvasive brachial artery SBP, and the SphygmoCor instrument was used to measure the noninvasive central
artery SBP. The consistency and correlation of different measurement methods were analyzed. Results The invasive
central artery SBP (126.9±19.5 mmHg) was significantly lower than the invasive radial artery SBP (138.9±
25.8 mmHg) and the noninvasive brachial artery SBP (138.6±17.7mmHg) (1 mmHg=0.133kPa) (all P<0.001). In
estimating the non-invasive central arterial SBP, invasive radial arterial pressure and non-invasive brachial arterial
pressure were used in combination with systolic pressure / diastolic pressure and mean pressure / diastolic pressure,
a total of 4 models. There was no significant difference between the invasive central artery SBP and the noninvasive
central artery SBP calculated by the four methods (P>0.05), but there was a significant positive correlation
(r≥0.622, P<0.001). Bland-Altman mapping analysis showed that 93.9% of the points in the central artery SBP
calculated using noninvasive brachial artery pressure compared with the invasive central artery SBP were within the
consistency limit. ROC curve analysis showed that when noninvasive brachial artery pressure was used to calculate
central artery SBP, systolic/diastolic pressure or mean/diastolic pressure correction was used, and there was no
significant difference in the detection ability of central hypertension (P=0.24). Conclusion Non-invasive and
invasive peripheral arterial blood pressure can not truly reflect central arterial blood pressure; non-invasive central
SBP has good correlation and consistency with invasive direct measurement values. Non-invasive central arterial
SBP has certain value in the diagnosis of central hypertension.

基金项目:

国家自然科学基金面上项目(81670377);上海市优秀青年基金(2017YQ065)

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