Lamb Tyler S, Thakrar Amar, Ghosh Mahua, Wilson Merne P, Wilson Thomas W
Department of Medicine and Cardiovascular Risk Factor Reduction Unit, University of Saskatchewan, Saskatoon, SK, Canada.
Clin Invest Med. 2010 Feb 1;33(1):E54-62. doi: 10.25011/cim.v33i1.11838.
To compare blood pressure readings obtained with two commonly used oscillometric monitors: Omron HEM 711 AC (OM) and Welch-Allyn 52000 series NIBP/oximeter (WA) with mercury sphygmomanometers (Merc) in subjects with atrial fibrillation.
We recruited 51 hemodynamically stable subjects with atrial fibrillation. Fifty four subjects in normal sinus rhythm served as controls. Supine blood pressure readings in each arm were recorded simultaneously using one monitor and Merc. The second monitor then replaced the first and readings were repeated. Merc was then switched to the opposite arm, and both monitors retested. Apical heart rates were ascertained with a stethoscope. We used the averaged, same arm Merc readings as "gold standard".
Automated blood pressure readings were obtained in all control subjects and in all but three of those with atrial fibrillation. Both monitors, and operators, noted a difference between apical and radial/brachial pulse rates: apical-recorded: Merc 6.1 + or - 15.0; OM 5.5 + or - 13.7; WA 10.0 + or - 21.2 beats per minute. Both monitors were accurate in controls: over 90% of readings were within 10 mmHg of averaged Merc, and both achieved European Hypertension Society standards. In subjects with atrial fibrillation, about one quarter of all oscillometric readings differed from Merc by more than 10 mmHg. Both falsely high and falsely low readings occurred, some up to 30 mmHg. There was no relation between accuracy and heart rate.
Single blood pressure readings, taken with oscillometric monitors in subjects with atrial fibrillation differ, often markedly, from those taken manually. Health care professionals should record multiple readings manually, using validated instruments when making therapeutic decisions.
比较两种常用的示波血压监测仪（欧姆龙HEM 711 AC（OM）和伟伦52000系列无创血压/血氧饱和度监测仪（WA））与汞柱式血压计（Merc）在心房颤动患者中所测得的血压读数。
我们招募了51名血流动力学稳定的心房颤动患者。54名窦性心律正常的受试者作为对照。使用一台监测仪和Merc同时记录每个手臂的仰卧位血压读数。然后更换第二台监测仪并重复读数。随后将Merc换到对侧手臂，并对两台监测仪重新进行测试。用听诊器确定心尖心率。我们将同一手臂Merc的平均读数作为“金标准”。
所有对照受试者以及除3名心房颤动患者外的所有患者均获得了自动血压读数。两台监测仪以及操作人员均注意到心尖与桡动脉/肱动脉脉搏率之间存在差异：心尖记录的数值：Merc为6.1±15.0；OM为5.5±13.7；WA为10.0±21.2次/分钟。两台监测仪在对照中均准确：超过90%的读数与Merc平均读数相差在10 mmHg以内，且均达到欧洲高血压学会标准。在心房颤动患者中，所有示波读数约四分之一与Merc相差超过10 mmHg。出现了读数假性偏高和假性偏低的情况，有些相差高达30 mmHg。准确性与心率之间无关联。
心房颤动患者使用示波监测仪所测得的单次血压读数与手动测量的读数往往存在显著差异。医疗保健专业人员在做出治疗决策时应使用经过验证的仪器手动记录多个读数。
