医学生舒张压测量过程中变音与消失观察

目的 ]　探讨用Korotkoff分期法的第 4期表示舒张压和第 5期表示之间的差别。 方法 ]　对 2 6 1例医学生采用汞柱式血压计间接测量法 ,测量两上肢的变音与消失的汞柱值。 结果 ]　两上肢舒张压变音和消失的均值男性均显著高于女性 (P <0 .0 0 1) ,而变音和消失均值与运动与否无关 (P >0 .0 5 )。舒张压变音发生率在左上肢为39 .8% ,右上肢为 39.5 % ,运动者变音发生率较不运动者显著增多 (P <0 .0 5 )。变音发生率与男、女性别无关 (P <0 .0 5 )。变音和消失之间的差值约为 15mmHg。结论 ]　舒张压的表示方法以第 5期消失的汞柱值较为合理。若以此值表示舒张压 ,则舒张压的标准可能相应下降。

Observation of the fourth and fifth Korotkoff sound in diastolic pressure measurement of medical students

Objective] To calculate the difference in diastolic pressure measured by the 4th and the 5th korotkoff sounds. Method] Indirect blood pressure of 261 medical students were measured by mercury column type sphygmomanometer. The 4th and the 5th korotkoff sound at both upper limbs of each student was measured. Results] The 5th korotkoff sound were higher in men than in women(P< 0.001 ).And there was no difference between the groups with physical activity and the groups without physical activity (P>0.05). K4was detected in 39.8% of left upper limb and 39.5% of right upper limb. The detective rate of K4 was higher in the groups with physical activity than in the groups without physical activity(P<0.05).But there was no difference between different sexes(P>0.05). The mean difference between the diastolic pressure measured by K4 and K5 was 15mmHg.Conclusions] The adoption of the 5th korotkoff sound to identify diastolic blood pressure is more reasonable.If K5 is adopted in preference to K4, consideration need to be given to lowering treatment thresholds for those with borderline or mild hypertension.