目的 探讨成人踝部和上臂无创血压差值及其影响因素，为医护人员利用踝部血压对疾病进行早期筛查诊断及治疗时提供参考。方法 检索中国知网、维普、万方、SinoMed、PubMed、The Cochrane Library、Embase、CINAHL数据库中关于研究成人踝部和上臂血压差异的自身对照试验，检索时间为建库至2023年6月6日，由2名研究者独立筛选文献、提取资料并利用澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心（2016）分析性横断面研究的质量评价工具对纳入的文献进行质量评价，使用RevMan 5.3及Stata 15.0软件进行数据分析。结果 最终纳入14篇文献，其中4篇国内文献、10篇国外文献，共20 275例研究对象。Meta分析结果显示，总体人群踝部与上臂收缩压差异有统计学意义（WMD=17.91 mmHg，P＜0.001）（1 mmHg=0.133 kPa）。亚组分析结果显示，性别是踝臂收缩压差值异质性高的主要原因；测量顺序、测量部位（左侧或右侧）和年龄对踝臂收缩压差值差异均无统计学意义(均P＞0.05)；心血管系统疾病组的踝臂收缩压差值较低（WMD=9.48 mmHg，P=0.005），终末期肾病组的踝臂收缩压差值较高（WMD=35.53 mmHg，P＜0.001）。结论 建议成人仰卧位时正常踝部收缩压阈值为108~158 mmHg。临床参考该值时，应注意考虑患者的性别、疾病等影响因素，未来需要更多高质量的原始研究以得出更有力的结论。

Objective To investigate the non-invasive blood pressure differences between the ankle and the upper arm in adults and its influencing factors，and to provide reference for medical and nursing staff to use ankle blood pressure for early screening，diagnosis and treatment of diseases.Methods Self-controlled trials on differences in ankle and upper arm blood pressure in adults were searched from CNKI，VIP，Wanfang，SinoMed，PubMed，The Cochrane Library，Embase and CINAHL databases.The time was from the inceptions to June 6，2023.Two researchers independently screened the literature，extracted the data，and used the quality evaluation tool of the JBI Evidence-Based Health Care Center of Australia (2016) to evaluate the quality of the included literature.RevMan 5.3 and Stata 15.0 software were used for data analysis.Results A total of 14 articles were included，including 4 domestic articles and 10 foreign articles，with a total of 20,275 study subjects.The meta-analysis results showed that there was a statistically significant difference in the ankle and upper arm systolic blood pressure in the general population （WMD=17.91 mmHg，P＜0.001）.The subgroup analysis results showed that gender was the main cause of heterogeneity in the ankle-arm systolic blood pressure difference.The measurement order，measurement site (left or right)，and age had no statistically significant effect on the ankle-arm systolic blood pressure difference (P＞0.05).The systolic blood pressure difference in the cardiovascular system disease group was significantly lower （WMD=9.48 mmHg，P=0.005），while the systolic blood pressure difference in the end-stage renal disease groupwas significantly higher （WMD=35.53 mmHg，P＜0.001）.Conclusions The normal ankle systolic blood pressure threshold for adults in the supine position is suggested to be 108-158 mmHg.When clinicians refer to this value，they should consider the influence of factors such as gender and disease.More high-quality primary studies are needed in the future to draw more robust conclusions.

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