某高校护理专科学生左右肱动脉血压差异情况分析

目的 了解护理专科生左右肱动脉血压之间差异,为指导实验教学及临床血压测量提供参考.方法 整群抽取乐山职业技术学院护理系普通专科2006和2007级在校护理专科生1 004名,分别用汞柱台式血压计和心电监护仪,按标准方法 由专人测量左右肱动脉血压.结果 专科生右侧肱动脉收缩压和舒张压均高于左侧(P值均＜0.01);绝大部分学生左右两侧肱动脉血压不等,50%以上为右侧高于左侧.结论 建议体检时测量右上肢血压,临床初次测量血压时测量双上肢血压.     

椎管内麻醉及复苏状态下踝部足背动脉血压与肱动脉血压临床研究

目的:对椎管内麻醉及复苏状态下踝部足背动脉血压与肱动脉血压相关性进行临床研究。方法:选取2013年2月~2014年2月间我院外科手术治疗患者50例,于其椎管内麻醉及复苏状态下进行踝部足背动脉血压与肱动脉血压的测量,记录并且对其相关性进行分析。结果:患者于麻醉前后、休克和使用血管活性药物时,踝部足背动脉与肱动脉的血压相应值无显著差异,p>0.05;而术后、复苏至血压恢复正常时,踝部足背动脉血压比肱动脉血压高,p<0.05。结论:于椎管内麻醉及复苏状态下机体踝部足背动脉血压与肱动脉血压相近,于复苏至血压正常时两部位血压值相关性高度显著,有一定的临床指导意义。     

健康人群肱动脉与桡动脉血压值比较

临床上以肱动脉作为血压测量部位,但其部位不易暴露,在抢救危重患者时十分不便。能否将桡动脉作为观察部位,其测量值是否准确,目前报道不多。为此,笔者于2006年10月对200例健康志愿者的肱动脉和桡动脉血压值进行了对比观察。     

脉压异常需要治疗吗

收缩压、舒张压、脉压与平均动脉压 血压广义的血压是指血液对血管壁产生的压力.而大家所熟知的血压,则是动脉血压的简称.全身各处的动脉粗细不等,压力也不一样,因此,根据测量的部位不同,血压又分为肱动脉血压、桡动脉血压、股动脉血压、主动脉血压(需用导管插入主动脉进行测量)等.大家日常所说的"血压",其实是肱动脉血压.     

基于PWTT的无创逐拍动脉血压检测的硬件系统设计与实现

目的:设计基于PWTT技术的无创逐拍动脉血压检测的硬件系统.方法:通过采集袖带压力、震荡波、柯氏音等信号,构建基于柯氏音法的单次血压测量系统;通过采集心电、心音、脉搏波、阻抗等多路生理信号,构建PWTT检测.该系统还通过线性放气、同步采集与校正等功能,进一步提高系统性能.结果:各路信号的采样率达到1000点/s,幅值分辨率为12位,时间分辨率为1 ms.单次血压测量系统的放气速率为:2～3 mmHg/s.可以实现单次血压和PWTT的同步采集与校正.结论:间歇式血压测量系统和PWTT逐拍检测系统.两个系统可同时工作,实现收缩压时刻或舒张压时刻同一心动周期内的血压和PWTT的实时校正;确保了逐拍动脉血压测量的准确性.基于该系统,我们将开展检测逐拍动脉血压的深入研究.     

电子定时自动血压计

电子定时自动血压计是一种气袖无创自动测量肱动脉血压的医疗器械。能自动充气、放气,用声光同步显示动脉音,不用听诊器即能测量收缩压与舒张压。能定时(2分钟、5分钟、15分钟、30分钟)自动测量血压。使其具有监护功能。在需要时还可随时启动手动开关,即时测量血压而不影响定时的时间间隔。该血压计如与手术室专用汞柱立式水银血压计或麻醉机     

柯氏音信号拾取装置的研制

目的：设计血压柯氏音信号采集装置,用该装置实现基于柯氏音方法的血压测量。方法：通过传音器采集柯氏音信号,根据柯氏音信号出现和消失对应的袖带压力得到收缩压和舒张压,将该装置的血压测量结果与人工听诊法测量结果对比,验证结果的可信性。结果：2种方式得到的血压结果差别很小,用该装置测量血压结果是可信的。结论：用该装置可实现测量血压,进一步可以研究用该方法实现基于柯氏音原理的血压自动测量。     

原发性高血压患者中心动脉血压与外周肱动脉血压的相关性

目的探讨原发性高血压患者中心动脉血压与外周肱动脉血压的相关性。方法从东莞寮步社区入选单纯原发性高血压患者,所有入选者进行标准的外周肱动脉和无创中心动脉压测量,并进行肾功能、血脂和血尿酸等检测,采用Spearman相关进行相关性分析。结果共入选491例高血压患者,平均年龄(56.2±10.1)岁,其中女性230例(46.8%),平均中心动脉收缩压和舒张压分别为(136.88±22.65)和(82.32±9.30)mm Hg,平均肱动脉收缩压和舒张压分别为(123.74±19.91)和(82.41±13.62)mm Hg,肱动脉收缩压与中心动脉收缩压呈相关(r=0.972,P0.01),肱动脉舒张压与中心动脉舒张压也呈正相关(r=0.993,P0.01)。结论原发性高血压患者中心动脉血压与外周肱动脉血压呈显著正相关性。无创中心动脉血压测量操作方便,适用于大规模临床检查。     

量血压时应该坐着还是躺着?

问:量血压时应该坐着还是躺着?答:血压测量是评估血压水平、诊断高血压以及观察降压疗效的主要手段。目前,在临床和人群防治工作中,主要采用诊室血压、动态血压以及家庭自测血压三种方法。诊室血压是目前评估血压水平和临床诊断高血压并进行分级的最常用方法。人在坐位状态下,肱动脉和心脏在一水平位置上,测量结果比较准。所以,诊室血压一般采用坐着量。动态血压白天以坐着量为主,晚上人需要睡觉,以躺     

测血压非右上臂不可吗

正在测量血压的实际操作中,很多人有这样的疑惑,为什么在医院测血压常选右侧手臂而非左臂?我们先来说说正确的血压测量方法吧。测量血压时应保持安静,坐在有靠背的座椅上,双腿自然下垂,上臂置于桌上,肱动脉与心脏位置平齐。将血压计袖带紧缚于被测者上臂,气囊中部对准肱动脉;袖带的松紧以恰能放进一个手指为宜。袖带下缘     

四川凉山州彝族学生肱动脉血压长期变化趋势分析

目的了解四川省凉山彝族学生肱动脉血压变化趋势,为当地青少年高血压等慢性非传染性疾病的预防控制政策、策略和措施的制定提供可靠依据。方法课题采用体格检查的方法对当地彝族学生健康状况进行动态观察,通过分层随机抽样的方法收集调查样本,采用体格检查法获取肱动脉血压监测结果。结果 1985年、2010年和2015年凉山彝族男生肱动脉收缩压均值分别为101.66mmHg、106.38mmHg和102.20mmHg,女生为102.43mmHg、104.17mmHg和101.45mmHg;1985年、2010年和2015年凉山彝族男生肱动脉舒张压均值分别为66.56mmHg、68.71mmHg和67.88mmHg,女生为67.12mmHg、67.09mmHg和67.88mmHg。结论凉山彝族学生肱动脉血压均值逐年上升趋势明显,今后当地学生常见病防治工作应重视慢性非传染性疾病的早期预防。     

卡托普利对高血压病患者内皮功能和非对称二甲基精氨酸的影响

目的 观察高血压病患者服用卡托普利后肱动脉内皮功能和血浆ADMA的变化.方法 入选35例高血压病患者口服卡托普利25 mg 3次/d,随访3月(高血压组),同时选择32例健康成人作为对照组,观察对照组和高血压病患者治疗前后肱动脉基础内径、充血后内径的变化以及采用HPLC法检测血浆非对称二甲基精氨酸(ADMA)的变化,并观察患者血压变化和药物的不良反应.结果 高血压病患者血压较对照组明显升高(P＜0.05).同对照组相比,高血压病患者肱动脉血流介导的血管舒张功能(FDM)显著降低(5.84±4.72 vs 12.7±3.47%,P＜0.05),血浆ADMA水平显著增加(0.87±0.35vs 0.58±0.36μmol/L,P＜0.05).经卡托普利治疗3月后,高血压病患者的血压下降,肱动脉FDM好转(9.75±3.28 vs 5.84±4.72%,P＜0.01),血浆ADMA水平降低(0.65±0.31 vs 0.87±0.35,μmol/L,P＜0.01).结论 卡托普利不仅可降低高血压病患者血压,同时可显著改善患者的内皮功能.     

踝肱指数在糖尿病足早期预防及护理中的应用

目的：探讨踝肱指数在糖尿病足早期筛查中的应用,并在此基础上进行早期干预,观察干预效果。方法：应用多普勒血流探测仪检测90例糖尿病患者肱动脉、足背动脉、胫后动脉血流波形图以及收缩压计算出踝肱指数（ABI）,并对高危（ABI<0.9）人群进行早期干预。结果：早期护理干预,能预防周围血管病变,可使患者延缓或不发生糖尿病足的发生。结论：通过超声多普勒血流探测仪对糖尿病患者进行筛查踝肱指数（ABI）筛查,能够为糖尿病足高危人群的早期干预提供重要的依据。     

Intertester reliability of brachial artery flow-mediated vasodilation using upper and lower arm occlusion in healthy subjects

The assessment of endothelial function as brachial artery flow-mediated vasodilatation is a widely used technique that determines the effect of risk factor intervention and may have the potential to predict the clinical benefit of antiatherogenic therapy. Previous studies suggest that flow-mediated dilation is greater using the upper-arm occlusion technique, but no data are available to compare intertester reliability between technicians. This study was undertaken to compare the amount of hyperemia between upper and lower occlusion techniques and to determine reproducibility between testers. Nineteen healthy adults, ages 25 to 50, were included in the study. Brachial artery vasodilatation was measured 1 and 3 minutes post cuff deflation and was compared with the baseline and expressed as a percent change. There was a tester effect in the percent change in diameter across all measurements. The results of this study reveal inconsistencies between testers when using a blood pressure cuff to induce hyperemia for the assessment of endothelial function through brachial artery flow-mediated vasodilation. However, upper arm as compared to lower arm blood pressure cuff occlusion results in significantly greater hyperemia and vasodilatation, even though there was a difference in measurements between testers.     

Quality of Korotkoff sounds: bell vs diaphragm, cubital fossa vs brachial artery

Comparison of clarity of Korotkoff sounds was made between those heard with the bell or diaphragm of the stethoscope and between those heard over the cubital fossa or more proximally and medially over the maximal brachial artery pulse--during indirect sphygmomanometry. Multiple measurements were made by two trained technicians on 48 supine adults. The measurements were balanced as to stethoscope-head/arm-placement combinations, stethoscope used, control of the pressure bulb, and use of right or left arm. The Korotkoff sounds were heard better with the bell of the stethoscope placed over the brachial artery pulse (BB) than with the diaphragm placed over the cubital fossa (DC). The former combination (BB) gave significantly higher blood pressure estimates for systolic blood pressure and fourth phase diastolic blood pressure than the latter combination (DC).     

一种基于脉搏波的无创连续血压测量方法

提出一种基于脉搏波的无创连续血压测量方法。该方法通过提取人体肱动脉脉搏波的特征参数,根据逐步回归分析建立的血压特征方程估计人体每搏的血压,实现无创连续血压测量。实验结果表明,采用此方法测得的血压与水银血压计测得的血压具有很好的一致性,收缩压与舒张压的平均差值都小于3mmHg,标准误差都小于5mmHg。     

有高血压家族史血压正常的青少年血管内皮功能改变

目的分析有高血压家族史但血压正常的青少年肱动脉内皮功能和血管活性物质的变化。方法对30例有高血压家族史、本人血压正常的青少年（家族史阳性组）和30例无高血压家族史、血压正常青少年（对照组）,以高分辨率超声测定肱动脉血流介导内皮依赖性舒张功能（FMD）,测量身高、体重、体质指数（BMI）、血压、血总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）和一氧化氮（NO）、血浆内皮素（ET-1）。结果与健康对照组相比,家族史阳性但血压正常的青少年的FMD和NO降低（P〈0．05）,ET-1虽升高但两组差异无统计学意义。结论有高血压家族史的青少年即使在血压正常时,已发生内皮依赖性舒张功能降低、血清NO水平下降。     

Best reproducibility of the ankle-arm index was calculated using Doppler and dividing highest ankle pressure by highest arm pressure

BACKGROUND AND OBJECTIVE: To investigate which method of ankle-arm index (AAI) measurement in terms of selected arteries and blood pressure devices yields the highest reproducibility. STUDY DESIGN AND SETTING: In this cross-sectional study, duplicate AAI measurements were obtained at the right and left side in 320 postmenopausal women. Analyses were done as proposed by Bland and Altman and intraclass correlation coefficients were calculated. RESULTS: The mean and standard deviation (SD) of the first and second systolic blood pressure (SBP) measurement separately did not differ from the mean and SD of the duplicate SBP measurements averaged. Coefficients of repeatability and intraclass correlation coefficients were comparable when the ankle SBP was measured in the posterior tibial artery or dorsalis pedis artery. Coefficients of repeatability as well as the intraclass correlation were better when the SBP in the brachial artery was measured with Doppler than with Dinamap. CONCLUSIONS: To achieve the best reproducibility and smallest systematic difference in the AAI, single SBP measurements should be obtained by Doppler in the brachial artery, posterior tibial artery and dorsalis pedis artery. The AAI should be calculated for each foot separately by dividing the highest ankle SBP by the highest arm SBP.     

Vascular structure and function in women: relationship with body mass index

BACKGROUND: The purpose of the present study was to compare endothelial function in lean (body mass index [BMI]=18.0-24.9 kg/m2); overweight (BMI=25-29.9 kg/m2); and obese (BMI>30 kg/m2), healthy, eumenorrheic women. METHODS: Eighteen lean, 22 overweight, and 19 obese eumenorrheic middle-aged women were studied. Vascular structure and function were assessed via non-invasive ultrasound imaging of the carotid and brachial arteries. Body composition, blood pressure, fasting blood lipids, glucose, and insulin also were measured. RESULTS: The groups demonstrated significantly (p<0.001) different mean values for total body, lean body, and fat masses. The obese group demonstrated significantly (p<0.05) elevated fasting glucose and insulin levels and lower high-density lipoprotein levels as compared to the lean group. The overweight group also demonstrated elevated fasting glucose levels as compared to the lean group (p<0.05) with no significant difference from the obese group. Only systolic blood pressure differed among the three groups, being elevated in the obese group compared to the lean group (p<0.05). The obese group demonstrated significantly (p<0.05) elevated carotid artery lumen diameter, carotid artery wall cross-sectional area, and brachial artery lumen diameter with significantly (p<0.05) lower flow-mediated dilation as compared to the lean group. The overweight group demonstrated elevated carotid artery wall cross-sectional area and brachial artery lumen diameter as well as lower flow-mediated dilation as compared to the lean group (p<0.05). CONCLUSIONS: The results of this study support the hypothesis that carotid artery wall cross-sectional area is elevated and flow-mediated dilation reduced in overweight and obese eumennorheic women as compared to lean counterparts in relation to BMI classification.     

踝肱指数、血压节律与颈动脉内-中膜厚度关系研究

目的探讨踝肱指数(Ankle brachial pressure index,ABI)及动态血压节律(ambulatory blood pressure rhythm,ABPR)与颈动脉内-中膜厚度(carotid intima-medial thickness,IMT)的关系。方法入选的92名2型糖尿病合并高血压患者测量ABI,动态血压监测并计算昼夜血压节律,测量颈动脉IMT,进行详细病史采集,检测生化指标,记录研究对象的年龄、身高、体重等。根据动态血压节律将入选患者分成2组:即杓形组与非杓形组,进行各检测指标参数比较。以颈动脉IMT为因变量,将年龄、ABI、体重指数(BMI)、尿微量白蛋白、血清生化指标、病史为自变量作多元逐步回归分析。分别比较血压节律、ABI单项异常,二者异常及二者正常时颈动脉IMT增厚的检出率。结果杓型血压与非杓型血压组各参数比较,ABI低于杓型组,差异有统计学意义,颈动脉IMT与各影响因素进行多、元逐步回归分析,进入回归方程的因素有ABI;血压节律、ABI单项异常较二项联合检查时颈动脉IMT增厚的阳性率低。结论血压节律的异常可以造成血管壁损伤;联合观察ABI和动态血压节律的变化较单独测量对大血管病变有更好的预见性。