腕部与上臂血压以及腕间与臂间血压差的比较

Comparison of wrist and upper-arm blood pressure, and of inter-wrist and inter-arm blood pressure differences

    摘要
  • 摘要:
    目的 比较腕部血压与上臂血压的测值差异，探讨腕间血压差与臂间血压差之间的关系。
    方法 纳入2024年8月10日到12月31日在南昌大学第二附属医院就诊患者603例，平均年龄(54.75±15.3）岁，其中合并高血压503例（83.4%），糖尿病203例（34.5%），冠心病50例（8.3%），慢性肾脏病8例（1.3%）。分别测量双侧腕部和上臂的血压，比较同侧腕部及上臂之间的收缩压和舒张压值。同时计算收缩压和舒张压的腕间血压差，并分析臂间血压差和腕间血压差的相关性。使用Bland-Altman方法分别评估腕部与臂部血压之间的一致性，以及腕间与臂间血压差之间的一致性。
    结果 纳入研究对象的腕部血压高于上臂血压收缩压：（130.14±20.00）比（122.32±17.91）mmHg，t=–19.821，P＜0.001；舒张压：（81.72±13.52）比（76.39±10.97）mmHg，t=–16.853，P＜0.001。腕部血压与上臂血压之间呈强正相关（收缩压r=0.864，P＜0.001；舒张压r=0.792，P＜0.001）。腕间血压差高于相应的臂间血压差收缩压差：4(2,7)比3(1,5) mmHg，Z= −7.296，P＜0.001；舒张压差：3(1,6)比2(1,3) mmHg，Z= −7.995，P＜0.001。然而，腕间收缩压差与臂间收缩压差的相关性无统计学意义，腕间舒张压差与臂间舒张压差之间仅存在较弱的相关性（收缩压差r=0.048，P＜0.001；舒张压差r=0.079，P＜0.001）。一致性分析表明，腕间血压差与臂间血压差之间的一致性较低（ICC＜ 0.1）。
    结论 腕部血压比上臂血压高；腕间血压差高于臂间血压差；腕间血压差与臂间血压差之间的一致性较低。

     

    Abstract:
    Objective To compare the differences between wrist blood pressure and upper-arm blood pressure measurements, and to explore the relationship between inter-wrist blood pressure differences and inter-arm blood pressure differences.
    Methods A total of 603 patients who visited the Second Affiliated Hospital of Nanchang University from August 10 to December 31, 2024, were enrolled. The average age was (54.75±15.3) years. Among them, 503 (83.4%) had hypertension, 203 (34.5%) had diabetes, 50 (8.3%) had coronary heart disease, and 8 (1.3%) had chronic kidney disease. Bilateral wrist and upper-arm blood pressures were measured. Systolic and diastolic blood pressures between the wrist and upper arm on the same side were compared. Inter-wrist systolic and diastolic differences were calculated, and correlations between inter-arm and inter-wrist differences were analyzed. Bland–Altman analysis was used to evaluate the agreement between wrist and arm blood pressures, as well as between inter-wrist and inter-arm blood pressure differences.
    Results Wrist blood pressure was higher than upper-arm blood pressure systolic: (130.14±20.00) vs (122.32±17.91) mmHg, t=–19.821, P＜0.001; diastolic: (81.72±13.52) vs (76.39±10.97) mmHg, t=–16.853, P＜0.001. Wrist blood pressre was strongly correlated with upper-arm blood pressure (systolic: r=0.864, P＜0.001; diastolic: r=0.792, P＜0.001). Inter-wrist blood pressure differences were greater than inter-arm blood pressure differences systolic: (4.25±4.89) vs (2.57±2.19) mmHg, t=–6.308, P＜0.001; diastolic: (5.22±5.53) vs (3.52±4.39) mmHg, t=–8.303, P＜0.001. However, the correlation between inter-wrist and inter-arm systolic blood pressure differences was not statistically significant, and only a weak correlation was observed between inter-wrist and inter-arm diastolic blood pressure differences (systolic: r=0.048, P＜0.001; diastolic: r=0.079, P＜0.001). Consistency analysis indicated low agreement between inter-wrist and inter-arm blood pressure differences, with intraclass correlation coefficient (ICC)＜0.1.
    Conclusions Wrist blood pressure is higher than upper arm blood pressure. Inter-wrist blood pressure differences were greater than inter-arm blood pressure differences. The agreement between inter-wrist and inter-arm differences is low.

     

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