电子血压计与水银血压计测量值的差异.pdf

電子血壓計與水銀血壓計測量值的差異 Differences of Blood Pressure Measurement Between Mercury Sphygmomanometer and Electronic Devices 陳亮恭 林明憲 黃信彰 陳振文 家庭醫學科 期刊名稱 journal 北市醫學雜誌 卷 vol 期 issue Issue 4 年代 year 2004 摘要 背景 高血壓病患的長期血壓控制與其預後的關聯已被多方面的證實 對高血壓的病患而言 只要平均的舒張壓可以降低5 6毫米汞柱便可以降低35 40 腦中風的危險與20 25 冠狀動 脈心臟血管疾病發生的風險 因此 準確的血壓測量對於長期高血壓控制便顯得十分重要 在一般門診當中 電子血壓計的使用十分廣泛 但是其準確性長期以來也一直得到廣泛的討 論 目的 本研究的目的在於比較一般門診常使用的電子血壓計與手測水銀血壓計的準確性 以驗證一般門診中使用電子血壓計的便利性是否兼顧準確性 方法 本研究於2002年以台 北榮民總醫院家庭醫學部與台北市立陽明醫院家庭醫學科就診民眾為研究對象 不論其就診 原因為何 在徵得個案同意後 以兩分鐘為間隔 分別以手測水銀血壓計與三種門診常用之 電子血壓計進行血壓測量 並進一步比較其測量所得之數值 以驗證其不同測量值間的準確 性 結果 於研究期間總計有六十名個案參與研究 平均年齡 69 9 12 6歲 其中52名為男性 其手測水銀血壓計測量之平均收縮壓為125 8 18 7毫米汞柱 平均縮張壓為75 5 10 4毫米汞 柱 而其餘三廠牌之電子血壓計所測得之平均收縮壓分別為128 6 18 4毫米汞柱 129 3 17 1毫 米汞柱與126 0 12 0乏毫米汞柱 而其平均輸張壓分別為 72 9 10 6毫米汞柱 69 5 12 0毫米汞柱 與72 7 10 4毫米汞柱 在比較其測量值之後 以電子血壓計測得之輸張壓較手測水銀血壓計 之測量值顯著為低 P 0 018 P 0 001與P 0 003 而電子血壓計所測得之收縮壓測量值則較水銀 血壓計所測得數值為高 不過僅某一廠牌達到統計上顯著的意義 P 0 094 P 0 006與P 0 852 以水銀血壓計所測得之收縮壓測量值與三種廠牌之電子血壓計所測得之血壓值顯示高度的相 關 相關係數為0 76 0 86與0 84 P 值均小於0 05 而輸張壓的測量結果亦同 相關係數為0 6 9 0 56與0 78 P值均小於0 05 結論 電子血壓計的測量值與手測的水銀血壓計測量值具有高 度的相關性 不過 電子血壓計所測得之收縮壓較水銀血壓計之測量值為高 且輸張壓測量 值明顯較水銀血壓計為低 這樣的結果可能來自於電子血壓計內部之敏感度校正 為求得正 確的血壓測量值 這樣的結果值得臨床上進一步調整 Abstract Background The prognostic significance of ideal blood pressure BP control in hypertensive patents was well established In hypertensive patients reduction of diastolic BP by 5 6 mmHg would reduce 35 40 risk in stroke and 20 25 of risk in coronary heart disease Therefore accurate BP measurement in the daily practice is crucial Electronic sphygmomanometers provide convenience but their accuracy had been debated extensively The purpose of this study was to compare the accuracy of three different brands of electronic sphygmomanometers with the mercury sphygmomanometer so that we can balance the convenience and accuracy in outpatient clinic Methods In 2002 we recruited subjects who visited Department of Family Medicine Taipei Veterans General Hospital and Taipei Municipal Yang Ming Hospital for study Every individual took BP measurements irrespective of underlying diseases by mercury sphygmomanometer and three other different electronic devices at 2 minute interval Comparisons of the measurement data were done by student s t test and Pearson correlation Results In total 60 subjects mean age 69 9 12 6 years 52 males and 8 females were recruited The mean reading of mercury sphygmomanometer was 125 8 18 7 mmHg for systolic BP SBP and 75 5 1 0 4 mmHg for diastolic BP DBP SBP readings of three different electronic devices were 128 6 18 4 mmHg 129 3 17 1 mmHg and 126 0 20 2 mmHg respectively Readings of DBP were 72 9 1 0 6 mmHg 69 5 12 0 mmHg and 72 7 10 4 mmHg respectively DBP readings taken by electronic devices were significantly lower than mercury sphygmomanometer p 0 01 8 p 0 001 and p 0 003 respectively the SBP readings by electric devices were all higher than mercury sphygmomanometer but only one achieved statistical significance p 0 094 p 0 006 and p 0 852 respectively Good correlation was observed between electronic devices and the mercury sphygmomanometer in both SBP correlation coefficient were 0 76 0 86 and 0 84 respectively p all 0 05 and DBP correlation coefficient was 0 69 0 56 and 0 78 respectively p all 0 05 readings Conclusion The consistency of BP measurements between electronic devices and the mercury sphygmomanometer was confirmed However the BP readings from electroni