| 杨芬芬,李婧.诊室血压、自动化诊室血压、家庭血压和日间动态血压测量的对比研究[J].安徽医药,2026,30(8):1656-1660. |
| 诊室血压、自动化诊室血压、家庭血压和日间动态血压测量的对比研究 |
| A comparative study of office blood pressure, automated office blood pressure, home blood pressure and daytime ambulatory blood pressure measurement |
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| DOI：10.3969/j.issn.1009-6469.2026.08.034 |
| 中文关键词: 血压测定 自动化诊室血压 家庭血压测量 白大衣高血压 动态血压 隐匿性高血压 |
| 英文关键词: Blood pressure determination Automated clinic blood pressure Home blood pressure monitoring White coat hyper-tension Ambulatory blood pressure Masked hypertension |
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| 中文摘要: |
| 目的探究诊室血压测量(OBPM)、自动化诊室血压(AOBP)测量、家庭血压测量(HBPM)和日间动态血压测量(dABPM)诊断高血压的价值。方法横断面研究。纳入 2022年 9月至 2023年 9月就诊于武汉科技大学附属天佑医院病人 403例，受试者均进行 OBPM、AOBP、HBPM、dABPM4种方法测量，收集血压测量数据，采用重复测量方差分析比较组间血压、心率的测量差值， McNemar检验、 Kappa检验和 Bland-Altman图用于比较不同血压测量方法的诊断一致性。结果 AOBP收缩压 /舒张压［( 134.95±18.34)mmHg/(81.91±12.25)mmHg(1 mmHg=0.133 kPa)］的平均值低于 OBPM的平均值［( 139.15±20.64)mmHg/(84.08±13.65)mmHg］，高于 dABPM［( 130.64±13.93)mmHg/(76.06±9.75)mmHg］、 HBPM［( 130.02±13.12)mmHg/(78.67±10.09) mmHg］的平均值(均 P<0.001)； AOBP心率( 72.81±10.18)次 /分低于 OBPM(74.68±12.58)次 /分( P<0.001)，高于 HBPM(70.26± 8.92)次 /分( P<0.001)与 dABPM心率( 72.13±9.98)次 /分差异无统计学意义( P=0.175)。以 24 h动态血压监测为标准， HBPM、 OBPM、AOBP诊断高血压，的灵敏度分别为 72%、67%、79%，特异度分别为 87%、74%、67%，HBPM、OBPM、AOBP与 24 h动态血压测量间的诊断一致性为中等( Kappa值分别是 0.60、0.41、0.43)。 HBPM在诊断白大衣性和隐匿性高血压方面具有高特异度(92%、95%)和阴性预测值( 90%、97%)。结论与 dABPM相比， OBPM、AOBP的平均血压显著升高，而家庭的平均收缩压差异无统计学意义。 AOBP可降低但不能完全消除白大衣效应， HBPM检测诊断白大衣高血压及隐匿性高血压的特异度较高，二者可分别作为动态血压测量、 OBPM的补充方法。 |
| 英文摘要: |
| Objective To explore the value of office blood pressure monitoring (OBPM), automated office blood pressure (AOBP)monitoring, home blood pressure monitoring (HBPM), and daytime ambulatory blood pressure monitoring (dABPM) in diagnosing hyper.tension.Methods Cross-sectional study.403 patients who visited the Tianyou Hospital Affiliated to Wuhan University of Science andTechnology from September 2022 to September 2023 were included, all subjects underwent measurements using four methods: OBPM,AOBP, HBPM, and dABPM, and blood pressure measurement data were collected. Kappa test and Bland-Altman plot were used to com-pare the diagnostic consistency of different blood pressure measurement methods.Results The average systolic/diastolic blood pres-sure of AOBP [(134.95 ± 18.34) mmHg/(81.91 ± 12.25) mmHg (1 mmHg=0.133 kPa)] was lower than the average value of OBPM[(139.15 ± 20.64) mmHg/(84.08 ± 13.65) mmHg], and higher than the average values of dABPM [(130.64 ± 13.93) mmHg/(76.06 ±9.75) mmHg] and HBPM [(130.02 ± 13.12) mmHg/(78.67 ± 10.09) mmHg] (all P<0.001). The heart rate measured by AOBP (72.81±10.18) beats/min was lower than that measured by OBPM (74.68±12.58) beats/min (P<0.001), but higher than that measured by HBPM (70.26±8.92) beats/min (P<0.001). There was no statistically significant difference in heart rate measured by AOBP compared to dAB.PM (72.13±9.98) beats/min (P=0.175).With 24 h ambulatory blood pressure monitoring as the standard, the sensitivity of HBPM, OB-PM and AOBP in the diagnosis of hypertension was 72 %, 67 % and 79 %, respectively, and the specificity was 87 %, 74 % and 67 %,respectively. The diagnostic consistency between HBPM, OBPM, AOBP and 24 h ambulatory blood pressure monitoring was moderate (Kappa values were 0.60, 0.41 and 0.43, respectively). HBPM was high in the diagnosis of white coat and concealment.Conclusions Compared with ABPM, the average blood pressure of OBPM and AOBP was significantly higher, while the average systolic blood pres-sure of the family was not significantly different. Automated clinic blood pressure can reduce but cannot completely eliminate the white coat effect. The specificity of HBPM measurement in the diagnosis of white coat and masked hypertension is high. They can be used assupplementary methods for ambulatory blood pressure and OBPM, respectively. |
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