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柯氏音与示波法袖带血压计:听诊法与动态脉搏血压测量的比较

Korotkoff sound versus oscillometric cuff sphygmomanometers: comparison between auscultatory and DynaPulse blood pressure measurements.

作者信息

Chio Shiu-Shin, Urbina Elaine M, Lapointe Jeffery, Tsai Jeffrey, Berenson Gerald S

机构信息

Pulse Metric, Incorporated, Vista, CA, USA.

出版信息

J Am Soc Hypertens. 2011 Jan-Feb;5(1):12-20. doi: 10.1016/j.jash.2010.10.005. Epub 2011 Jan 26.

Abstract

Listening to Korotkoff sounds (K-sounds) to determine systolic and diastolic blood pressure (BP) has been the standard for noninvasive BP measurement in medical practices for nearly 100 years. It is the essential tool used for evaluation and assessment of patients with hypertension and risks of cardiovascular diseases (CVD) by physicians and nurses despite limited understanding of the nature of K-sounds. Analyzing cuff oscillometric signals to obtain BP has been the foundation of most digital BP monitors available today. DynaPulse is an oscillometric digital BP monitor that records and analyzes subtle changes of pulse waveforms during the course of a BP measurement while cuff pressure slowly decreases from above systolic to below diastolic. This study compares systolic and diastolic readings obtained by K-sound method following the Bogalusa Heart Study protocol and BP measured by DynaPulse (DP2000A) monitor, in order to better understand the nature and difference between K-sound and oscillometric methods. Analysis of means and differences is applied to BP data collected from 803 subjects examined in the Bogalusa Heart Study. The results indicated: 1) DynaPulse systolic was 9 mm Hg higher (P < .0001) than Phase 1 (K1) systolic, 2) DynaPulse diastolic was 5 mm Hg lower (P < .0001) than Phase 4 (K4), and 3) is less than 1 mm Hg higher than Phase 5 (K5) diastolic (P < .0001), when compared with K-sound auscultatory measurement. Understanding the methods and differences of DynaPulse oscillometric and K-sound BP measurements is important for clinic BP screening and self-BP monitoring, as well as future research to improve hypertension and CVD managements.

摘要

近100年来,通过听诊柯氏音(K音)来确定收缩压和舒张压一直是医学实践中非侵入性血压测量的标准方法。尽管对K音的本质了解有限,但它仍是医生和护士用于评估高血压患者及心血管疾病(CVD)风险的重要工具。分析袖带示波信号以获取血压一直是当今大多数数字血压计的基础。DynaPulse是一种示波数字血压计,它在血压测量过程中,当袖带压力从高于收缩压缓慢降至低于舒张压时,记录并分析脉搏波形的细微变化。本研究比较了按照博加卢萨心脏研究方案通过K音法获得的收缩压和舒张压读数,以及通过DynaPulse(DP2000A)血压计测量的血压,以便更好地了解K音法和示波法之间的本质及差异。对从博加卢萨心脏研究中检查的803名受试者收集的血压数据进行均值和差异分析。结果表明:1)与K音听诊测量相比,DynaPulse收缩压比第1期(K1)收缩压高9 mmHg(P < 0.0001);2)DynaPulse舒张压比第4期(K4)低5 mmHg(P < 0.0001);3)比第5期(K5)舒张压高不到1 mmHg(P < 0.0001)。了解DynaPulse示波法和K音法血压测量的方法及差异,对于临床血压筛查和自我血压监测以及未来改善高血压和CVD管理的研究具有重要意义。

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