Park M K, Lee D H, Johnson G A
Department of Pediatrics, University of Texas Health Science Center, San Antonio 78284-7804.
Pediatrics. 1993 Apr;91(4):761-5.
Comparing blood pressure (BP) obtained in the arm with that obtained in the thigh or calf is important in the diagnosis of aortic coarctation. However, normative mean and range of differences in BP between the arm and lower extremity sites are not available for normal children. It is also not known how accurately the differences in BP between the arm and the lower extremity sites predict the pulsed Doppler estimation of systolic pressure (SP) gradient across an aortic coarctation. To resolve these questions, the authors obtained two BP measurements by an oscillometric (Dinamap) method in the arm, thigh, and calf in 74 healthy children aged 4 to 16 years. Oscillometric BP was also obtained in 21 children aged 3 to 17 years with preoperative or postoperative aortic coarctation and BP gradients were compared with that estimated by the pulsed Doppler method. Overall, SP was higher in the thigh and calf than in the arm. The gradients in SP expressed as arm SP minus calf SP [S(A-C)] and arm SP minus thigh SP [S(A-T)] were significantly greater in children 4 through 8 years old than in those 9 to 16 years old. The S(A-C) was -9.3 (+/- 7.4 SD) mm Hg in the 4- through 8-year group and -5.0 (+/- 6.9 SD) mm Hg in the 9- to 16-year group. The S(A-T) was -7.1 (+/- 6.8 SD) mm Hg in the 4- through 8-year group and -2.4 (+/- 7.7 SD) mm Hg in the 9- to 16-year group.(ABSTRACT TRUNCATED AT 250 WORDS)
比较手臂测得的血压（BP）与大腿或小腿测得的血压对于主动脉缩窄的诊断很重要。然而，正常儿童手臂与下肢部位血压差异的标准均值和范围尚无定论。手臂与下肢部位血压差异预测主动脉缩窄处收缩压（SP）梯度的脉冲多普勒估计的准确性也未知。为解决这些问题，作者采用示波法（Dinamap）在74名4至16岁健康儿童的手臂、大腿和小腿处进行了两次血压测量。还对21名3至17岁术前或术后主动脉缩窄儿童进行了示波血压测量，并将血压梯度与脉冲多普勒法估计的结果进行比较。总体而言，大腿和小腿的SP高于手臂。4至8岁儿童中，以手臂SP减去小腿SP [S（A - C）]和手臂SP减去大腿SP [S（A - T）]表示的SP梯度显著大于9至16岁儿童。4至8岁组的S（A - C）为-9.3（±7.4 SD）mmHg，9至16岁组为-5.0（±6.9 SD）mmHg。4至8岁组的S（A - T）为-7.1（±6.8 SD）mmHg，9至16岁组为-2.4（±7.7 SD）mmHg。（摘要截选至250字）
