长期锻炼对中心动脉压和外周血压的影响

目的：通过对平板运动心脏负荷试验前后中心动脉压与外周动脉压的对比，探讨无创中心动脉压检测在血压管理及长期锻炼的健康人群健康鉴定中的应用价值。方法：志愿者139人，受检者卧床休息10min后测量运动前左上肢肱动脉血压、心电图（ECG）、用无创主动脉脉波分析仪测量中心动脉压：启动运动试验直至达到目标心率后停止运动，受检者卧床休息6min后测量ECG和无创中心动脉压。结果：139例平板运动试验受检者运动前后外周动脉收缩压（SBP）及外周动脉舒张压（DBP）差异有显著性（P〈0．05）。而此时中心动脉收缩压（CSBP）及中心动脉舒张压（CDBP）差异没有显著性（P〉0．05）；运动前后中心脉压（CPP）差异没有显著性（P〉0．05）。结论：①运动前后外周动脉血压差异显著时中心动脉压无差异。②无创中心动脉压检测比外周动脉压测量具有更好的稳定性、准确性。③长期锻炼的健康者心脏负荷试验前后中心与外周血压的变化规律与一般人群有所不同。④无创中心动脉压检测在高血压诊断与血压管理应用中具有重要的临床价值。

Changes in Central and Peripheral Blood Pressures by Cardiac Stress Test among the Healthy Subjects with Long Term Physical Exercise

Objective： To examine the value of non-invasive central arterial blood pressure in blood pressure management and the physical fitness assessment among the healthy subjects with long term physicalexercise, by comparing the central and peripheral arterial blood pressure changes before and after treadmill stress test. Method： Among the 139 subjects, The subjects were allowed to rest on the examination table for 10 minutes, and then received the blood pressure measurement at the left brachial artery with mercury sphyg- momanometer, ECG and the central arterial blood pressure measurement with a noninvasive aortic pulse wave analyzer. The subjects were asked to undergo the treadmill stress test until the target heart rates were reached. The subjects are allowed to lie on the examination table for six minutes before having their ECG and central arterial blood pressure examined. Result： Among the 139 subjects, there are significant changes in peripheral arterial systolic blood pressure （SBP） and peripheral diastolic blood pressure （ DBP） before and after the treadmill stress test （ P〈0.05 ）. However, there were no significant changes in the central systolic blood pressure （ CSBP） and central diastolic blood pressure （ CDBP） before and after the treadmill stress test （P〉0.05 ）. Furthermore, there＇s no significant difference in central pulse pressure before and after the treadmill stress test （ P〉0.05）. Conclusion： ①There is no significant difference in central pulse pressure before and after the treadmill stress test when there were significant differenced peripheral blood piessure. ② Comparing with peripheral arterial blood pressure, non-invasive central arterial blood pressure is more stable, accurate and sensitive. ③The c jects with long term physical exercise hanges in central and peripheral blood pressure among the healthy subare different from that among the general public. ④Non-invasive eentral arterial pressure measurement is very valuable to the hypertension diagnosis and blood pressure management in the clinical practice.