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[WHC2011]中心血压测量方法与内皮细胞功能研究进展——Alberto Alvolio 教授专访

作者:国际循环网   日期:2011/11/23 16:57:21

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《国际循环》:为什么我们需要测量中心血压?为什么对血压的测量要如此精确呢?为什么血压的波形如此重要?


    <International Circulation>:When you’re creating waveforms [algorithms] so that you can estimate the central pressure and the intracranial pressure, how much are you relying on standard waveforms [algorithms] or do you create waveforms[algorithms] for individuals? 
  《国际循环》:当您创建波形算法以估量中心血压和颅内压时,您有多大程度是依靠标准波形算法来进行的?您有没有设计出针对个体的波形算法呢?
    Prof. Alvolio :Waveforms are not created and there is no normalization. These algorithms are models. The waveforms are measured. The algorithms are such that in one case with the sigma core, for example, is a constant filter for adults. Attempts have been made to individualize that filter for specific cases. If that is done, the added value is a few percent of difference which is quite interesting. Anatomically, the size of the vessels in adults, the arms, the stiffness, the thickness of those vessels, is not a factor that varies a lot. When we developed that model, we were quite surprised of the consistency of this model, especially at the low frequency end where one finds most of the power of the pulse. We thought that that should be a reasonable estimate of central pressure. In fact, the errors in that estimation are of the order or less than the error made in calling out diastolic pressure from the cuff. Usually that measurement of diastolic pressure isa matter of judgment.  The operator makes a judgment when that heart sound is muffled. Automatic algorithms have the same property. So those errors are of the same order. The question is that if we can accept those sorts of measurements, we should be able to accept these other sorts of measurements that have similar errors. 
    Alvolio教授:波形不是被创建出的,而且并没有标准化的波形。这些算法都只是一些模型。波形是被测量出的。这些算法是这样的,比如在一种有Σ核心的情况下这些算法在在成人中是一个常数滤波器。我们已经做出努力来使这些滤波器更加个体化以适用于特殊的情况。如果能做到这些,增值将是很少百分比的差异,这是非常有趣的。在解剖学上,成人血管的大小以及这些血管的分支、僵硬度和血管壁厚度常常并不是变化很大。当我们设计出这种模型时,我们非常惊奇于这种模型的一致性,特别是在低频端发现了脉搏最有力的部分。我们认为这就是合理估测中心动脉压的方法。实际上,这种估测方法的误差和袖带测量舒张压中的误差相差无几,甚至还更小。通常对舒张压的测量是一种评价方法。操作者们根据心音的消失做出评价。自动的算法也有同样的作用。因此这些误差没有太大的差别。问题是如果我们能接受这些已经被接受的测量方法,我们就应该能接受这些误差相似的新的测量方法。

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中心血压波形算法内皮细胞Alberto Alvolio

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