【摘要】 目的探讨直接血压与间接血压的相关性及其影响因素与假性高血压的关系。方法208例临床需要行冠状动脉造影的患者,男150例,女58例,平均年龄(60.2±10.9)岁。在动脉穿刺成功后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,造影结果由2位以上专家判断并记录。根据冠状动脉造影结果分为2组,冠状动脉正常组(104例)和冠心病组(104例)。根据有无高血压病分为正常血压组(95例)和高血压病组(113例)。并测量身高、体质量、臂围(AC)、腰围(WC)、臀围(HC),计算体质量指数(BM I)、腰围/臀围(WHR)、腰围/身高(WH tR)、平均血压(MBP)、直接与间接收缩压(SBP)差值(S-S)和直接与间接舒张压(DBP)差值(D-D)。结果①直接血压与间接血压明显相关,SBP、MBP、DBP相关系数分别为0.88、0.76、0.58(P<0.01)。②高血压病组、冠心病组、女性直接SBP与间接SBP相关性好,而直接DBP与间接DBP相关性较差,SBP、MBP、DBP相关系数分别为0.52、0.48、0.49(P<0.01)。③直接血压总体上高于间接血压,S-S:-39~40 mm Hg(1 mm Hg=0.133 kPa),(6.35±12.50)mm Hg;D-D:-47~55 mm Hg,(5.63±11.17)mm Hg。S-S≤-10 mm Hg组与S-S>-10 mm Hg组,S-S≤-10mm Hg组的AC、WC、HC、WHR、WH tR、BM I和年龄是更高的,仅BM I差别有统计学意义(P<0.05)。D-D≤-10mm Hg组与D-D>-10 mm Hg比较,D-D≤-10 mm Hg组AC,WC,HC,WHR,WH tR和BM I是更高的,仅AC差别有统计学意义(P<0.05)。分析AC与直接间接SBP、DBP的差值的关系发现:冠心病组AC与D-D相关,相关系数为0.27(P<0.01)。高血压组S-S与AC相关,相关系数为-0.22(P<0.05)。结论①直接血压与间接血压有明显相关性,其中SBP相关性最好,MBP次之,DBP最差(尤其是高血压病组、冠心病组和女性组);②AC是影响直接与间接血压测量值差值的重要因素,冠心病组AC影响DBP,而高血压病组AC影响SBP;③BM I高和AC大者易高估间接血压而出现假性高血压的情况。更多还原

【Abstract】 Objective To investigate the influencing factors of relationship between the invasive blood pressure(BP) and the non-invasive BP and pseudohypertension(PHT).Methods A total of 208 patients,150 males,58 females,((60.25±)(10.97)) years old,whose invasive and non-invasive BP value were measured respectively three times before coronary angiography(CAG) was performed.Arteriographic findings were evaluated by more than two experts and recorded.These patients were divided into control group and coronary artery disease(CAD) group according to angiographic finding,and into normal BP(NBP) group and essential hypertention(EH) group according to the criterion of EH.Body height,body mass,upper arm circumference(AC),waist circumference(WC) and hip circumference(HC) were measured.Then body mass index(BMI) was calculated,waist hip ratio(WHR),waist height ratio(WHtR),mean BP(MBP) and the difference between invasive BP and non-invasive BP(S-S,D-D) were measured.Results ①Non-invasive BP value was correlated with invasive BP value.The correlation coefficients of systolic BP,mean BP,diastolic BP were(0.88),(0.76),(0.58) respectively(P<(0.01)).②Non-invasive systolic BP correlated well with invasive systolic BP among CAD group,EH group and women,while their non-invasive diastolic BP and invasive BP correlated badly,and their correlation coefficients of systdic BP,mean BP,diastolic BP were respectively(0.52),(0.48),(0.49)(P<(0.01)) ③Invasive BP was higher than non-invasive BP as a whole,S-S:(-39)-40(mm Hg),((6.35)±(12.50))(mm Hg);D-D:(-47)-55(mm Hg),((5.63)±(11.17))(mm Hg),AC,WC,HC,WHR,WHtR,BMI and age of S-S≤(-10)(mm Hg) group were higher than those of (-10)(mm Hg)<S-S<10(mm Hg) group,only the difference of BMI had statistical significance(P<(0.05)).AC,WC,HC,WHR,WHtR and BMI D-D ≤(-10)(mm Hg) were higher than than those of(-10)(mm Hg)< D-D<10(mm Hg) group,only the difference of AC had statistical significance(P<(0.05)).Analysis of the relationship between AC and the difference of BP showed:among CAD group,AC was correlative with D-D,its correlation coefficient was(0.27)(P<(0.01)),AC and S-S correlated in EH group,its correlation coefficient was(-0.22)(P<(0.05)).Conclusion ①Non-invasive BP correlated closely with invasive BP,among SBP,MBP and DBP,SBP was best,MBP was inferior,DBP was worst(especially among EH group,CAD group and female group).②AC was an important factor influencing the difference of invasive and non-invasive BP.AC influenced DBP in CAD group,while AC influenced SBP in EH group.③Higher AC and BMI value may result in higher non-invasive BP value and rate of PHT phenomena.更多还原