快速毛细血管血糖测定和静脉血浆血糖测定的临床对比研究

目的:评价稳豪型血糖仪的稳定性及其测定指尖毛细血管血糖(CGF)、手臂毛细血管血糖(CGA)与自动生化仪测定静脉血浆血糖(VG)的相关性。方法:选取正常血糖、轻度高血糖、和中高度高血糖的指尖血样用稳豪型血糖仪做批内和批间测定。221例糖尿病或非糖尿病患行常规静脉血浆血糖测试的同时用稳豪型血糖仪测定指尖毛细血管血糖和(或)手臂毛细血管血糖。结果:3种不同浓度的血糖标本测定的批内、批间变异系数均小于5%。VG与CGF、VG与CGA、CGF与CGA3组的空腹血糖及餐后2h血糖相关性良好,r均在0.900以上。血糖浓度<7.0mmol/L时CGA明显高于VG,r=0.757;血糖浓度>11.1mmol/L时,r=0.667,其余各组在不同血糖浓度的相关性均在0.850以上。VG与CGF及VG与CGA的相对差值均在7%以下。结论:稳豪血糖仪有良好的稳定性,CGF及CGA均可比较精确的反应空腹及餐后2h各种血糖浓度的VG并可对VG做初略的估算。     

糖尿病患者低血糖反应时手臂毛细血管血糖值的可靠性研究

目的研究低血糖反应时手臂毛细血管血糖（CGA）、指尖毛细血管血糖（CGF）及自动生化血糖仪测定静脉血浆血糖（VG）的关系。方法选择2006年7-11月住院强化治疗的糖尿病患者中出现低血糖反应者34例,发生低血糖反应即刻和口服50%葡萄糖后20 min,由操作熟练的2名护士,1名护士抽取静脉血由实验室用全自动生化仪测定VG,另1名护士即刻用Free Style利舒坦快速血糖仪同时测定CGA与CGF。结果低血糖反应时CGA（4.04±0.68）mmol/L,明显高于CGF（2.85±0.22）mmol/L与VG（2.64±0.21）mmol/L（P〈0.001）;口服50%葡萄糖后20 min CGA（7.03±1.20）mmol/L,明显低于CGF（9.15±1.69）mmol/L与VG（9.27±1.70）mmol/L（P〈0.001）;CGF与VG在低血糖反应时及口服50%葡萄糖后20 min相关分析r值分别为0.616、0.983,P〈0.001。结论低血糖反应时测量手臂毛细血管血糖要慎重,应该测量指尖血糖或静脉血糖为宜。     

指尖及手臂部位测定毛细血管血糖和静脉血浆血糖的对比研究

目的研究手臂毛细血管血糖监测的可行性。方法用利舒坦血糖仪对住院糖尿病患者同步测定空腹及餐后2h的手臂毛细血管血糖、指尖毛细血管血糖与同时抽取静脉血用全自动生化仪测定的血浆血糖值作比较。将患者对针刺手臂、指尖的痛觉评分作比较。结果空腹及餐后2h手臂毛细血管血糖与指尖毛细血管血糖及静脉血浆血糖的均值比较,差异无统计学意义;空腹及餐后2h静脉血浆血糖、指尖毛细血管血糖、手臂毛细血管血糖三组相关性良好,r值均在0.950以上,P〈0.001;手臂、指尖的痛觉评分比较,P〈0.001。结论手臂毛细血管血糖监测能精确反应糖尿病患者空腹及餐后2h血糖,且针刺手臂疼痛较轻,患者依从性高。     

毛细血管血微量法血糖及静脉血浆血糖测定的相关性探讨

监测与控制血糖水平是糖尿病患者的关键步骤,不同样本、不同方法、不同仪器均会使血糖测定结果受到影响。静脉血浆血糖（VPG）是一种目前较精准、可靠的测定血糖方法,但其采血量多、测定时间较长、费用高,     

即时检验血糖仪检测指尖毛细血管血及抗凝静脉全血的对比分析

选取我院2012年7月~2013年8月收治的56例糖尿病患者,采取其指尖毛细血管血及抗凝静脉全血分别应用快速血糖仪进行检测,对比分析两者血液血糖检测结果。结果运用即时检验血糖仪检测指尖毛细血管血及抗凝静脉全血,其血糖检测值之间比较,差异无统计学意义(P0.05)。指尖毛细血管血及抗凝静脉全血在即时检验血糖仪中的检测结果无明显的差距,临床上对糖尿病患者进行检测时可以根据患者的具体情况给予合适的方法。     

三诺金准血糖仪测定末梢毛细血管、静脉血糖水平准确性的研究

目的研究三诺金准血糖仪检测末梢毛细血管血糖(CBG)、静脉血糖(VPG)的准确性,其与全自动生化分析仪测定VPG、拜安康血糖仪测定CBG结果的相关性。方法糖尿病及非糖尿病患者80例在空腹状态及餐后2h同时用三诺金准血糖仪测定CBG、VPG;采用全自动生化分析仪测定VPG;采用拜安康血糖仪测定CBG,对比结果相关性。结果三诺金准血糖仪测定的CBG、VPG与全自动生化分析仪测定VPG、拜安康血糖仪测定CBG的结果均有良好相关性,r均大于0.95。三诺金准血糖仪测定CBG、VPG与全自动生化分析仪测定结果对比偏倚率分别为-5.2%和-7.3%,符合国家卫生和计划生育委员会规定的合格标准。结论采用三诺金准血糖仪测定CBG、VPG均有较高准确性,能准确反映血糖水平。     

血糖仪测毛细血管血糖及全自动生化仪测静脉血浆血糖结果分析

由于糖尿病发病率的增高及人们经济条件的改善，血糖仪在我们临床工作及病人血糖的自我监测中运用越来越广泛。其操作简单、便于携带、方便快捷的优点，受到人们的欢迎。但有患者及医务工作人员对其准确性提出质疑。现将笔者在临床工作中所得20例次同一时间内经两种方法测得的血糖数值进行比较分析。     

儿科患者毛细血管血糖与静脉血清血糖值的对比分析

目的评价快速血糖仪测定儿科患者毛细血管血糖与生化分析仪测定静脉血清血糖之间的差别，探讨血糖仪测定儿科患者毛细血管血糖的临床意义。方法用拜安易快速血糖仪测定15例新生儿（A组）和30例非新生JL（B组）患者的毛细血管血糖（CBG），同时用葡萄糖氧化酶法全自动生化分析仪测定患儿的静脉血清血糖（VSG），用统计学方法进行数据处理，并进行相关性分析。结果两组患儿的CBG与VSG结果差异均无统计学意义（P〉0.05），且二者呈高度相关（P〈0.001）。结论应用快速血糖仪测定儿科患者毛细血管血糖减轻了患儿、特别是新生儿的疼痛，而且该方法快速、简便，采取必要措施可获取可靠结果，符合儿科临床血糖筛查要求。     

将随机指尖血糖测定纳入入院护理体检常规

临床上新病人人院时的护理体检常规内容包括测量生命体征、观察意识及精神状态等,我科2003年1月～2007年12月对2 615例新人院病人护理体检时全部加测指尖血糖,发现血糖异常者446例,进一步检查确诊为糖尿病者314例,其中新发现糖尿病病人127例,占糖尿病病人总数的40.4%,所以我们认为对新人院病人测定随机指尖血糖能尽早发现血糖异常,从而有助于指导治疗及进一步的检查,建议将随机指尖血糖测定纳入人院护理体检常规.     

血糖仪与全自动生化分析仪检测血糖的结果对比

目的：探讨用罗氏Glucotrend（乐康全）血糖仪测定毛细血管血糖（CBG）与全自动生化分析仪测定静脉血清糖（VSG）之间有无差别和可比性,为临床提供可靠数据。方法：随机选取血糖测定患者80例,全部测试采集空腹血,用罗氏Glucotrend血糖仪测定末梢血全血糖,采血后立即测试,血糖仪试纸为配套试纸条,仪器用质控液校正,用迈瑞BS-380全自动生化分析仪测定同侧静脉血糖,采血后2h内测试,血清是静脉血抽取后立即离心分离获得。结果：通过对80例血糖仪与全自动生化分析仪的血糖检测结果进行对比分析,表明两种检测方法在检测血糖结果中差异无统计学意义（P〉0．05）。结论：在血糖仪的测定范围内,两种方法都是可靠的,但血糖仪测定范围受限,过高或过低时无数据显示,全自动生化分析仪可弥补血糖仪之不足,因此用罗氏Glucotrend血糖仪测定血糖具有快速、简便、准确、疼痛少的特点,给糖尿病患者血糖检测和急诊快速检测血糖带来方便,对临床用药具有很大的指导意义。     

Relationships of glucose concentrations in capillary whole blood, venous whole blood and venous plasma

We studied the difference in glucose levels between capillary and venous whole blood during 75-g oral glucose tolerance test (OGTT) in 75 healthy subjects. Capillary and venous whole blood glucose values were measured by HK-G6PD method after deproteinization. The post-loaded glucose levels in capillary blood were significantly higher than those in venous blood, and the mean values of capillary and venous difference at 30, 60, 90, 120 and 180 min were 1.37, 1.40, 1.07, 0.95 and 0.52 mmol/l, respectively, with the maximum difference at 60 min. No correlation was found in the magnitude of the differences in glucose between capillary and venous blood specimens. We determined the inaccuracy of six self-monitoring blood glucose devices relative to the reference method using venous plasma, venous whole blood and capillary whole blood from 31 diabetic patients. The differences of mean values of venous whole blood and capillary whole blood, and venous whole blood and venous plasma, and capillary whole blood and venous plasma were 9.6%, 11.3% and -3.2%, respectively. The range of bias and Sy/x were 0.31-1.06 mmol/l and 0.71-1.07 mmol/l, respectively, compared to the reference method using venous plasma.     

Ferritin concentrations in plasma from capillary (finger prick) blood and venous blood compared

Investigating the feasibility and validity of determining plasma ferritin concentration in blood obtained by finger prick, we studied 29 adults (ages 21-49 years) and 35 children (ages 14-66 months). Blood was sampled simultaneously in the same subject from both the antecubital vein (venous blood) and by finger pricking (capillary blood). The plasma was obtained by centrifugation. Ferritin concentration was determined by immunoradiometric analysis. Ferritin concentration in plasma from capillary blood was significantly higher than in venous plasma (p less than 0.01). This difference was more marked in children. The correlation between ferritin from the two blood sources was highly significant (r2 = 0.945 and 0.994 for samples from adults and children, respectively), and the slopes of the respective regression lines in both children and adults were significantly different from 1 (p less than 0.0001). We conclude that, despite the close association between the two procedures, the determination of ferritin concentration in capillary blood plasma overestimates the concentration of ferritin in venous blood plasma.     

Differences between capillary and venous blood glucose during oral glucose tolerance tests.

The simultaneous capillary and venous blood glucose concentrations were measured during 36 oral glucose tolerance tests performed in 36 postmenopausal women. Three of the subjects had chemical diabetes mellitus. In samples obtained before and 120-180 min after the glucose load the differences between capillary and venous blood glucose concentrations were low, whereas samples taken after 15-90 min showed a mean capillary-venous difference of 1.8 mmol/l. This is higher than previously stated by the World Health Organization and the British Diabetes Association. If the definitions that were recommended by these two bodies are used for defining whether the result of an oral glucose tolerance test is to be considered 'normal' or 'abnormal', the present results indicate that the verdict will in some cases be influenced by the route by which the blood was obtained.     

耳垂血、指尖血肝功能测定准确性的探讨

目的探讨耳垂血、指尖血肝功能测定的准确性。方法29例志愿者同时采集耳垂血、指尖血和静脉血,并分析其丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)测定值的差异。结果耳垂血、指尖血ALT与静脉血相比较差异无统计学意义(P>0.05),但耳垂血、指尖血AST均高于静脉血,差异有统计学意义(P<0.01),定量分析分别高14.21%和9.68%。结论耳垂血、指尖血ALT与静脉血相似,但AST显著高于静脉血,临床测定时需作相应校正。     

血糖仪测定失血性休克病人血糖值可靠性研究

创伤后机体会发生一系列应激性变化,其中交感神经-肾上腺髓质的兴奋会导致血糖的应激性升高.且血糖增高值与疾病预后有一定的关系,血糖越高预后越差[1],故合理控制血糖是抢救危重症病人的有利措施.准确快速地提供血糖值对治疗至关重要,笔者对106例创伤性休克病人行快速血糖测定与静脉血血糖测定相比较,探讨两者之间的关系,为临床治疗提供准确数据.     

Estimation of in vivo capillary or venous blood glucose concentration from analysis on stored venous blood or its plasma and use in quality control of near-patient glucose tests

Glucose concentrations were determined in capillary and venous blood and in venous plasma from 100 consecutive patients referred to an oral glucose tolerance test. The capillary blood was immediately transferred to a haemolysing and glucose stabilizing solution and frozen within 4h. Venous blood was drawn in heparin-sodium fluoride tubes and stored for 0, 4 or 24h at 4 or 20 degrees C. Aliquots of the venous blood were then treated in the same way as the capillary blood. The primary tubes were centrifuged, and aliquots of the plasma were stabilized, as described. All specimens from the same sampling event were analysed in the same analytical series on EBIO compact. Deming linear regression equations y = a + bx were calculated to estimate the glucose concentration in one specimen from that in a differently treated specimen e.g.: B(cB:fPt)---Glucose (0h) = 0.61 + 0.897*P(vB;fPt)-Glucose (24h. 20 C). n = 100, SD(y/x) = 0.25 mmol/L and B(vB) Glucose (0h) = 0.53 + 0.897*P(vB)--Glucose (24h. 20 degrees C), n = 196, SD(y/x) = 0.26 mmol,/L. The non-analytical part of the standard deviation of the ratio between the near-patient test result and its predicted value was 0.038 for both of the above predictions. In conclusion, the analytical (including sampling) variation of near-patient tests of glucose can be assessed by laboratory analysis on mailed, heparin-fluoride stabilized venous blood or on plasma samples made from the mailed blood.     

Estimation of in vivo capillary or venous blood glucose concentration from analysis on stored venous blood or its plasma and use in quality control of near-patient glucose tests

Glucose concentrations were determined in capillary and venous blood and in venous plasma from 100 consecutive patients referred to an oral glucose tolerance test. The capillary blood was immediately transferred to a haemolysing and glucose stabilizing solution and frozen within 4 h. Venous blood was drawn in heparin-sodium fluoride tubes and stored for 0, 4 or 24 h at 4 or 20 C. Aliquots of the venous blood were then treated in the same way as the capillary blood. The primary tubes were centrifuged, and aliquots of the plasma were stabilized, as described. All specimens from the same sampling event were analysed in the same analytical series on EBIO compact. Deming linear regression equations y=a + bx were calculated to estimate the glucose concentration in one specimen from that in a differently treated specimen e.g.: B(cB;fPt)--Glucose (0h) = 0.61+0.897*P(vB;fPt)--Glucose (24h, 20 ° C), n=100, SD B(vB) - Glucose (0 h)= 0.53+ 0.897*P (vB)--Glucose (24 h, 20 ° C), n=196, SD y|x =0.26 mmol/L. The non-analytical part of the standard deviation of the ratio between the near-patient test result and its predicted value was 0.038 for both of the above predictions. In conclusion, the analytical (including sampling) variation of near-patient tests of glucose can be assessed by laboratory analysis on mailed, heparin-fluoride stabilized venous blood or on plasma samples made from the mailed blood.     

Prevalence-dependent decision limits for the early detection of type 2 diabetes mellitus in venous blood, venous plasma and capillary blood during glucose challenge.

BACKGROUND: The glycemia decision limits recommended by WHO/ADA for type 2 diabetes detection are derived from clinical signs in advanced stages of the disease. Since insulin secretion patterns and sensitivitity are impaired at the beginning of type 2 diabetes, this stage may be better suited to identify decision limits with higher diagnostic efficiency than those currently applied. METHODS: Oral glucose tolerance tests were performed in 300 subjects. Glucose concentrations were measured at 30-min intervals in venous plasma, venous blood and capillary blood. Insulin concentrations in venous plasma, an insulin sensitivity index and body mass index were used to indicate a type 2 diabetic state. A multiple logistic regression procedure was "trained" using only subjects "clearly" considered to be non-diseased or diseased based on an oral glucose tolerance test according to WHO criteria. This insulin algorithm was applied to the whole study group, leading to definitive classification into the non-diseased or the diseased group. This a posteriori classification was used to identify cutoff values with the highest diagnostic efficiency. RESULTS: The diagnostic efficiency was significantly higher when decision limits lower than the WHO recommendations for glucose concentrations were applied in a preselected subpopulation and in all three sample systems tested, e.g., 9.49 mmol/L (171 mg/dL) for venous plasma and 8.94 mmol/L (161 mg/dL) for capillary blood in the 2-h post-load state. The optimized and WHO 2-h cutoff values corresponded to a disease prevalence of 28% and approximately 5% (20% in the fasting state), respectively. Diagnostic efficiency was higher in the 2-h post-load than in the fasting state. Combining fasting values with 2-h post-load values did not further improve the diagnostic efficiency. Glucose concentrations determined from capillary blood were as efficient as those from venous blood or plasma. The number of diabetic subjects detected differed considerably between capillary blood and venous plasma for the WHO/ADA cutoff values, but not for the optimized cutoff values. CONCLUSIONS: The efficiency of type 2 diabetes diagnosis can be improved by optimizing cutoff values according to disease prevalence. Unexpectedly, the optimized 2-h post-load cutoff was lower for capillary blood than for venous plasma. It is proposed to identify a risk group e.g., by characteristics of the metabolic syndrome in which the 2-h post-challenge concentration is determined using lower cut-off values than presently recommended.