Påhlsson Hans-Ivar, Laskar Carolina, Stark Karin, Andersson Anna, Jogestrand Tomas, Wahlberg Eric
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm Sweden.
Angiology. 2007 Aug-Sep;58(4):472-6. doi: 10.1177/0003319706294606.
To determine the optimal cuff width for measuring toe blood pressure in patients with lower limb ischemia, this experimental prospective study examined 20 patients with symptoms of peripheral arterial disease referred for vascular examination or vascular surgery. Toe blood pressure was measured hydrostatically by the pole test using cuffs of different widths. Pole test reflects the true physiological blood pressure value and was the reference method. Blood pressures obtained using the cuffs were related to this value and to patients' toe circumference. With the 2.5-cm cuff, the patients had a mean pole test toe blood pressure of 28 mm Hg (range, 6-55 mm Hg). Compared with pole test results, the toe blood pressure was 15.6 mm Hg (95% confidence interval [CI], 8-23 mm Hg) higher when measured using the 2.0-cm cuff (P < .001) and 4.5 mm Hg (95% CI, 0-9 mm Hg) higher when measured using the 2.5-cm cuff (P = .07). Using the 1.5-cm and 3.0-cm cuffs, the differences were 27.0 mm Hg (95% CI, 13-43 mm Hg) and -2.0 mm Hg (95% CI, -11 to 8 mm Hg), respectively. The cuff width greatly affects the obtained toe blood pressure value, and larger cuffs correspond better to the hydrostatic pressure. For clinical use and as a reporting standard, we propose that toe blood pressure measurements should be made using a 2.5-cm-wide cuff.
为确定测量下肢缺血患者趾部血压的最佳袖带宽度，本实验性前瞻性研究纳入了20例因外周动脉疾病症状前来接受血管检查或血管手术的患者。采用不同宽度的袖带，通过杆式试验以流体静力法测量趾部血压。杆式试验反映真实的生理血压值，为参考方法。使用袖带测得的血压值与该参考值及患者的趾围相关。使用2.5厘米宽袖带时，患者杆式试验测得的平均趾部血压为28毫米汞柱（范围为6至55毫米汞柱）。与杆式试验结果相比，使用2.0厘米宽袖带测量时，趾部血压高出15.6毫米汞柱（95%置信区间[CI]，8至23毫米汞柱）（P <.001），使用2.5厘米宽袖带测量时高出4.5毫米汞柱（95% CI，0至9毫米汞柱）（P =.07）。使用1.5厘米和3.0厘米宽袖带时，差异分别为27.0毫米汞柱（95% CI，13至43毫米汞柱）和 -2.0毫米汞柱（95% CI，-11至8毫米汞柱）。袖带宽度对所测得的趾部血压值影响很大，较宽的袖带与流体静压力更相符。对于临床应用及作为报告标准，我们建议应使用2.5厘米宽的袖带测量趾部血压。
