不同电子血压计测量肥胖人群血压的准确性
The accuracies of pulse wave and oscillometric electronic sphygmomanometers for blood pressure measurements in obese people
-
摘要: 目的比较脉搏波电子血压计和示波法电子血压计在肥胖人群中测量血压的准确性。方法于2015年9月在山东省莱芜市选择年龄≥18岁且体质量指数≥30kg/m2的男性和女性为研究对象。对每个研究对象利用四通管道同时连接台式水银血压计和电子血压计进行血压测量。以台式水银血压计的测量值作为金标准,采用组内相关系数(ICC)、Bland-Altman分析和允许总误差(ATE)/最大误差限(LER)区域比较2种电子血压计的测量结果。结果共纳入研究对象118人。脉搏波电子血压计与台式水银血压计测量收缩压和舒张压的ICC值分别为0.99(95%CI0.99~1.00)和0.96(95%CI0.90~0.98),示波法电子血压计与台式水银血压计相应的ICC值分别为0.98(95%CI0.97~0.99)和0.90(95%CI0.44~0.96)。一致性检验显示,2种电子血压计测量的收缩压的差值均值均接近0值参考线;舒张压的差值均值均位于0值参考线下方,其中示波法电子血压计距离0值参考线更远(-5.7比-2.6mmHg,P<0.05)。ATE/LER区域分析结果显示,2种电子血压计测量的收缩压均有>95%的测量值落在ATE区域;脉搏波电子血压计的舒张压测量值落在中间区域和LER区域的比例分别为4.2%和0%,示波法电子血压计相应的比例为19.5%和0.8%。结论脉搏波电子血压计和示波法电子血压计在对肥胖人群进行收缩压测量时均表现出较高的准确性,但在舒张压测量上表现出不同程度的低估,示波法电子血压计的低估现象尤为明显。Abstract: Objective To evaluate the accuracies of pulse wave and oscillometric electronic sphygmomanometers for blood pressure measurements in obese people. Methods Community-based men and women,aged≥18years whose body mass index(BMI)were 30kg/m~2 or more were recruited in Laiwu city,Shandong province in September2015. Four way pipe was used to link desktop mercury sphygmomanometer,electronic sphygmomanometer to subjects simultaneously. Blood pressure value recorded by desktop mercury sphygmomanometer was considered as golden standard. Intra-class correlation coefficient(ICC), Bland-Altman method and allowable total error(ATE)/limits for erroneous results zones(LER)zones were used for evaluating accuracy of two electronic sphygmomanometers compared to mercuries sphygmomanometer. Results A total of 118 subjects were enrolled. The ICC of pulse wave electronic sphygmomanometer-desktop mercury sphygmomanometer were 0.99(95% CI0.99-1.00)for systolic blood pressures and 0.96(95% CI0.90-0.98)for diastolic blood pressures. The ICC of oscillometric electronic sphygmomanometer-desktop mercury sphygmomanometer were 0.98(95% CI 0.97-0.99)for systolic blood pressures and 0.90(95% CI0.44-0.96)for diastolic blood pressures. Bland-Altman test showed that the mean systolic blood pressure difference closed to zero reference line,while the mean diastolic blood pressure difference was below the zero-reference line,especially in oscillometric sphygmomanometer(-5.7vs-2.6mmHg,P<0.05).ATE/LER zones analysis showed that more than 95% values for systolic blood pressures in two sphygmomanometers fell within the ATE zones. For diastolic blood pressure values in pulse wave electronic hygmomanometer,4.2% and 0% measured values fell within the intermediate zones and LER zones respectively while the corresponding proportions in oscillometric electronic sphygmomanometer were 19.5% and 0.8%. Conclusion This study indicated that both pulse wave and oscillometric electronic sphygmomanometers have good accuracies in systolic blood pressure measurement,however,underestimated diastolic blood pressure,particularly in oscillometric electronic sphygmomanometer in obese people.
下载: