Blank S G, West J E, Müller F B, Pecker M S, Laragh J H, Pickering T G
Cardiovascular Center, New York Hospital-Cornell University Medical Center, New York 10021.
Hypertension. 1991 Feb;17(2):225-33. doi: 10.1161/01.hyp.17.2.225.
Three types of auscultatory gaps, called G1, G2, and G3, that occur during blood pressure measurement have been identified by using wideband external pulse recording. We have previously shown that the wideband external pulse recorded during cuff deflation can be separated into three components (K1, K2, and K3), one of which (K2) is closely related to the Korotkoff sound. G1 occurs with cuff pressure just below systolic and is characterized by the presence of K1 and K2 with intermittent disappearance of K2. G1 gaps are related to a phasic decrease of arterial (systolic) pressure and were exhibited by 13 of 60 hypertensive patients. G2 gaps are related to a phasic increase of arterial (diastolic) pressure, occur when cuff pressure is just above diastolic, and are characterized by the presence of K1, K2, and K3 with intermittent disappearance of K2. Seven of 60 hypertensive patients exhibited a G2 gap. G3 gaps occur with cuff pressure between systolic and diastolic and are characterized by an underdeveloped or blunted K2 signal. Three of 60 hypertensive patients exhibited a G3 gap. The identification of auscultatory gaps in relation to the wideband external pulse provides a qualitative measure of their existence, can be of significant value in better understanding aspects of the auscultatory blood pressure measurement technique, and provides an objective basis with which to better understand the mechanisms that cause them.
通过使用宽带外部脉搏记录，已识别出在血压测量期间出现的三种听诊间隙，分别称为G1、G2和G3。我们之前已经表明，在袖带放气期间记录的宽带外部脉搏可分为三个成分（K1、K2和K3），其中之一（K2）与柯氏音密切相关。G1出现在袖带压力略低于收缩压时，其特征是存在K1和K2，且K2间歇性消失。G1间隙与动脉（收缩压）压力的阶段性下降有关，60例高血压患者中有13例出现该间隙。G2间隙与动脉（舒张压）压力的阶段性升高有关，出现在袖带压力略高于舒张压时，其特征是存在K1、K2和K3，且K2间歇性消失。60例高血压患者中有7例出现G2间隙。G3间隙出现在袖带压力处于收缩压和舒张压之间时，其特征是K2信号发育不全或减弱。60例高血压患者中有3例出现G3间隙。与宽带外部脉搏相关的听诊间隙的识别提供了对其存在的定性测量，在更好地理解听诊血压测量技术的各个方面可能具有重要价值，并为更好地理解导致这些间隙的机制提供了客观依据。
