Uhari M, Nuutinen M, Turtinen J, Pokka T
Department of Paediatrics, University of Oulu, Finland.
Lancet. 1991 Jul 20;338(8760):159-61. doi: 10.1016/0140-6736(91)90145-f.
Controversy exists over the value of measuring diastolic blood pressure (BP) in children, and over whether this should be measured at Korotkoff's fourth phase (K4) or fifth phase (K5) of pulse sounds. We measured diastolic BP in 3012 randomly selected Finnish children aged 6-18 years in 1980, and in 2885 of the same individuals in 1983 and 2500 in 1986. BP was measured with a standard mercury sphygmomanometer in 1980 and 1983, and with a random-zero sphygmomanometer in 1986. K4 was consistently absent in 187 individuals (3.2%) in 1980 and 1983, and in 155 individuals (6.2%) in 1986. K5 was absent in only 34 individuals (0.6%) in 1980/83 and 5 (0.2%) in 1986. The difference between mean K4 and K5 diastolic BP varied from 6.5 to 9.2 mm Hg depending upon age. K4 and K5 BPs showed good correlation in all age groups. Reliable and repeatable BP measurements in all age groups of children are best achieved with K5 as the indicator of diastolic BP.
关于测量儿童舒张压（BP）的价值，以及是否应在脉搏声音的柯氏音第四相（K4）或第五相（K5）测量舒张压，存在争议。1980年，我们对3012名随机选取的6至18岁芬兰儿童测量了舒张压，1983年对其中2885名同一儿童进行了测量，1986年对2500名进行了测量。1980年和1983年使用标准汞柱血压计测量血压，1986年使用随机零点血压计测量。1980年和1983年，187名个体（3.2%）始终未出现K4，1986年有155名个体（6.2%）未出现K4。1980/83年仅有34名个体（0.6%）未出现K5，1986年有5名个体（0.2%）未出现K5。根据年龄不同，K4和K5舒张压的平均值之差在6.5至9.2毫米汞柱之间。在所有年龄组中，K4和K5血压显示出良好的相关性。以K5作为舒张压指标，能够在所有年龄组的儿童中最佳地实现可靠且可重复的血压测量。
