接受扩血管药物治疗的患者应当检查中心动脉压,因为可以正确评价降压作用,而通过常规的肱动脉血压测定会低估降压作用。另外,有心脏病的患者应当检查中心动脉压,因为可以得到有关心脏后负荷的确切信息。
International Circulation: According to your recent research, estimated central SBP calculated with radial late SBP accorded well with aortic SBP measured by the invasive method. Can we say that noninvasive method can replace the invasive way?
Takazawa:Yes, that’s right.
We can estimate central systolic pressure well using non-invasive devices of aplanation tonometry. But the values of central pressures must be cautioned. HEM9000AI produces direct central systolic pressure based on the direct intra-arterial pressure. On the other hand, SphygmoCor produces central systolic pressure based on the cuff brachial artery pressure. So, the reduction in central blood pressure before and after the drug administration is same in both devices, but the values of central blood pressure are different now. The fundamental issue is that standard brachial cuff blood pressure measurement underestimate intra-arterial brachial systolic blood pressure by about 10 mmHg.
《国际循环》:根据你最新的研究,通过桡动脉晚期SBP来计算估计中心SBP与有创方法测得的主动脉SBP具有良好相关性。这是否意味着无创方法能够取代有创方法?
Takazawa教授:没错,通过测定平面压力波的无创设备,我们可以估算出中心SBP。但是,对于中心动脉压的数值要谨慎。HEM9000AI根据直接动脉压能够得出中心SBP。而SphygmoCor是根据袖套式血压计测得的肱动脉压得出中心SBP。因此,两个设备所测出的药物治疗前后中心动脉压的降幅是一致的,但是中心动脉压的数值并不相同。根本的问题是标准的袖套式血压计所测得的肱动脉血压比实际要低10 mm Hg。