外周与中心动脉血压差异性分析

目的比较外周与中心动脉血压的差异性，探讨外周高估或低估中心血压的影响因素和可能机制。方法选择住院患者72例，行诊断性冠脉造影62例，射频消融术建立动脉通路10例，年龄（56．64±15．41）岁，男38例，女34例。其中冠心病32例，原发性高血压18例，糖尿病5例，其他17例。术后同步记录升主动脉与股动脉压力波形，测量并分析外周及中心动脉血压，计算外周血压放大、脉压比率及脉搏波传导速度。结果①肱动脉收缩压与股动脉收缩压升降一致，两者有相关性（r=0．89，P〈0．01）；②外周动脉收缩压、舒张压及脉压与中心动脉相应值有显著差异（P〈0．05或P〈0．01）；外周可能相符或高或低于中心血压。③外周高估中心SBP（52．8％）多为中青年低危人群，外周放大与年龄呈负相关（r=-0．37，P〈0．05）；④外周低估中心SBP多见于老年人及高血压患者，老年人（〉60岁）外周血压与中心动脉血压差值较小（P〉0．05），两者平行变化趋势。结论①肱动脉袖带血压能稳定反映外周肌性动脉血压；②外周血压与中心动脉压之间存在差异；③外周血压放大是外周高估中心收缩压的主要原因；④中心动脉硬化可能与外周等于或低于中心收缩压相关。

An analysis of the differences between the peripheral arterial and the central arterial blood pressures

Objective To analyze the difference between the peripheral arterial pressure and the aortic pressure, and discuss the factors and possible mechanisms contributing to the overestimated peripheral blood pressure or the underestimated central blood pressure. Methods 72 patients （ aged 56.64 ± 15.41, 38 males, 34 females） were included in our research, of whom 62 patients underwent coronary angiography and 10 patients had radiofrequency current ablation to establish arterial passage. Of these patients, there were 32 cases of coronary heart disease, 18 cases of essential hypertension, 5 cases of diabetes mellitus and 17 cases of other diseases （patients with abnormal aortic curvature were excluded）. The simultaneous pressure waveforms of the ascending aorta and femoral artery were recorded postoperatively, and the PPP/CPP, CPP/PPP and PWV were calculated. Results ①The systolic blood pressure of the brachial artery was consistent with that of the femoral artery in variation, suggesting they were correlated with each other （ r = 0.89, P 〈 0.01 ） ; ②There were marked differences between the systolic blood pressure （SBP） and diastolic blood pressure （DBP） of the peripheral artery as well as the pulse pressure （PP） and those of the central artery （P 〈0.01 ） in that the former could be identical to or higher or lower than the central arterial pressures; ③Patients with overestimated peripheral SBP （52.8%） were mostly youth and the middle - aged, who were at low risk, with their PPP/CPP negatively correlated with age （ r = - 0.37, P 〈 0.05 ） ; ④The underestimated peripheral SBP （ P 〈 0.05 ） was chiefly found in the elderly （ 〉 60 years old） and the hypertensive patients, and in the former, the difference between the peripheral and aortic pressures was not remarkable （P 〉 0.05 ）, exhibiting a tendency of paralleled variations. Conclusion ①Brachial arterial blood pressure measured by cuff - wrapping could reflect the muscular blood pressure of the peripheral