Crossland D S, Furness J C, Abu-Harb M, Sadagopan S N, Wren C
Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
Arch Dis Child Fetal Neonatal Ed. 2004 Jul;89(4):F325-7. doi: 10.1136/adc.2003.034322.
To assess the variation in blood pressure (BP) between limbs in normal neonates. To assess whether comparison of arm and leg BP in neonates is reproducible enough to allow the difference to raise suspicion of coarctation of the aorta.
Infants recruited from the postnatal wards and the postnatal murmur clinic underwent echocardiography and BP measurement in each limb using a Dinamap Compact T 482210. The method of BP measurement was guided by a telephone survey of 40 UK neonatal units.
Forty healthy neonates underwent echocardiography and all had a normal aortic arch. BP was measured in 39. In three, BP in the arms was 20 mm Hg higher than in the legs. This gave a specificity of comparison of the upper and lower limb BPs of 92 (36/39) or a false positive rate of 8% (3/39). The standard deviation in BPs was 15.7 mm Hg between arms, 14.5 mm Hg between legs, and 11 mm Hg when the nearest arm and leg were compared.
With current measurement techniques, normal neonates may have a wide variation in BP between limbs. A difference of 20 mm Hg in isolation is more likely to be due to random variability in measurement than to coarctation of the aorta. If coarctation of the aorta is suspected, it can only be excluded or confirmed by echocardiography.
评估正常新生儿四肢血压（BP）的差异。评估新生儿手臂与腿部血压的比较是否具有足够的可重复性，以使差异引发对主动脉缩窄的怀疑。
从产后病房和产后杂音诊所招募的婴儿接受了超声心动图检查，并使用Dinamap Compact T 482210测量每个肢体的血压。血压测量方法由对40个英国新生儿病房的电话调查指导。
40名健康新生儿接受了超声心动图检查，所有新生儿的主动脉弓均正常。对39名新生儿进行了血压测量。其中3名新生儿的手臂血压比腿部血压高20 mmHg。上肢与下肢血压比较的特异性为92（36/39），即假阳性率为8%（3/39）。双臂血压的标准差为15.7 mmHg，双腿血压的标准差为14.5 mmHg，最近的手臂与腿部血压比较的标准差为11 mmHg。
采用当前的测量技术，正常新生儿四肢血压可能存在较大差异。单独20 mmHg的差异更可能是由于测量中的随机变异性，而非主动脉缩窄。如果怀疑主动脉缩窄，只能通过超声心动图排除或确诊。
