臂围调查与血压计袖带大小的合理选择

Arm Circumference and Selection of Appropriate Cuff Size

目的调查北京地区成人高血压病患者右上臂臂围的数值，为临床工作中合理选择血压测量袖带提供一定的指导。方法用横断面研究，连续入选了424名成人高血压病患者（其中男性占61．6％），经右上臂的中点测量所有病例的臂围。根据臂围的数值将患者首先分为3组：1组臂围在22～26cm之间（小个成人），2组臂围在27～34cm（标准成人），3组臂围〉34cm（大个成人）。再将患者分为两组：A组臂围〈32cm，B组臂围≥32cm。结果在全部入选高血压病患者中，臂围均值为（29．6±2．6）cm。82．8％的患者右臂臂围在27～34cm之间，只有8．96％的患者臂围在22~26cm之间。无论男性和女性患者，其臂围和体质量指数（BMI）与腰围（WC）都呈显著相关性（BMI：r=0．810，WC：r=0．725，P均〈0．01）。与A组比较，B组患者的血清肌酐、尿酸和三酰甘油都显著高于A组，而高密度脂蛋白胆固醇却显著低于A组。结论在当前临床实践中，需尽早采用气囊尺寸为13cm×30cm的袖带进行血压测量。另外，臂围增加可能与本地区高血压病患者代谢指标的紊乱相关。

Objective The aim of this study was to assess the distribution histogram of arm circumference （ AC） in adult hypertensives in Beijing area, and to establish which size of cuffs is most appropriate in clinical practice. Methods We conducted a cross-sectional survey in a cohort of 424 （male 61.6%） consecutive hypertensives patients. Arm circumference was measured at the mid-point of the right upper arm. Subjects were stratified in three groups： group 1 with AC between 22-26 cm （small size）, group 2 AC between 27-34 cm（medium size）, and group 3 AC great than 34 cm （large size）. Using AC of 32 cm as cutoff point, patients were subdivided as group A （AC〈32 cm, n=340） and group B（AC≥32 cm, n=84）. Results The average AC was （29.6 ±2. 6）cm with a range between 27-34 cm for 82.8% patients, while only in 8. 96% subjects the AC are below the mean value. A strong positive correlation between AC, body mass index （BMI） and waist circumference （BMI：r=0. 810, WC：r=0. 725, P〈0. 01） was found. BMI, blood serum creatinine, uric acid and triglyceride （TG） were significantly higher in group B, while high density lipid （HDL） was lower. Conclusion For accurate blood pressure measurements using size 13 cm× 30 cm cuff in practice is appropriated. The increase of AC may also represent some metabolic disorders in adult hypertensives.