Manios Efstathios, Vemmos Konstantinos, Tsivgoulis Georgios, Barlas Gerasimos, Koroboki Eleni, Spengos Konstantinos, Zakopoulos Nikolaos
Department of Clinical Therapeutics Alexandra Hospital, University of Athens, Athens, Greece.
Blood Press Monit. 2007 Jun;12(3):149-56. doi: 10.1097/MBP.0b013e3280b083e2.
This study aims to compare automatic oscillometric blood pressure recordings with simultaneous direct intra-arterial blood pressure measurements in hyperacute stroke patients to test the accuracy of oscillometric readings.
A total of 51 first-ever stroke patients underwent simultaneous noninvasive automatic oscillometric and intra-arterial blood pressure monitoring within 3 h of ictus. Casual blood pressure was measured in both arms using a standard mercury sphygmomanometer on hospital admission. Patients who received antihypertensive medication during the blood pressure monitoring were excluded.
The estimation of systolic blood pressure (SBP) using oscillometric recordings underestimated direct radial artery SBP by 9.7 mmHg (95% confidence interval: 6.5-13.0, P<0.001). In contrast, an upward bias of 5.6 mmHg (95% confidence interval: 3.5-7.7, P<0.001) was documented when noninvasive diastolic blood pressure (DBP) recordings were compared with intra-arterial DBP recordings. For SBP and DBP, the Pearson correlation coefficients between noninvasive and intra-arterial recordings were 0.854 and 0.832, respectively. When the study population was stratified according to SBP bands (group A: SBP<or=160 mmHg; group B: SBP>160 mmHg and SBP<or=180 mmHg, group C: SBP>180 mmHg), higher mean DeltaSBP (intra-arterial SBP-oscillometric SBP) levels were documented in group C (+19.8 mmHg, 95% confidence intervals: 12.2-27.4) when compared with groups B (+8.5 mmHg, 95% confidence intervals: 2.7-14.5; P=0.025) and A (+5.9 mmHg, 95% confidence intervals: 1.8-9.9; P=0.002).
Noninvasive automatic oscillometric BP measurements underestimate direct SBP recordings and overestimate direct DBP readings in acute stroke. The magnitude of the discrepancy between intra-arterial and oscillometric SBP recordings is even more prominent in patients with critically elevated SBP levels.
本研究旨在比较超急性卒中患者自动示波法血压记录与同步直接动脉内血压测量结果，以检验示波法读数的准确性。
共有51例首次发生卒中的患者在发病3小时内接受了同步无创自动示波法和动脉内血压监测。入院时使用标准汞柱式血压计测量双侧上臂的偶测血压。排除在血压监测期间接受抗高血压药物治疗的患者。
使用示波法记录估计收缩压（SBP）时，低估了桡动脉直接测量的SBP 9.7 mmHg（95%置信区间：6.5 - 13.0，P<0.001）。相比之下，将无创舒张压（DBP）记录与动脉内DBP记录进行比较时，发现有5.6 mmHg（95%置信区间：3.5 - 7.7，P<0.001）的正向偏差。对于SBP和DBP，无创记录与动脉内记录之间的Pearson相关系数分别为0.854和0.832。当根据SBP范围对研究人群进行分层时（A组：SBP≤160 mmHg；B组：SBP>160 mmHg且SBP≤180 mmHg，C组：SBP>180 mmHg），与B组（+8.5 mmHg，95%置信区间：2.7 - 14.5；P = 0.025）和A组（+5.9 mmHg，95%置信区间：1.8 - 9.9；P = 0.002）相比，C组的平均DeltaSBP（动脉内SBP - 示波法SBP）水平更高（+19.8 mmHg，95%置信区间：12.2 - 27.4）。
急性卒中患者中，无创自动示波法血压测量低估了直接SBP记录，高估了直接DBP读数。在SBP水平严重升高的患者中，动脉内和示波法SBP记录之间的差异幅度更为显著。
