套管针采血对胰岛素和C肽测定结果的影响

目的：探讨套管针采血对胰岛素和C肽测定结果的影响。方法：采用自身前后对照试验，对60名受试者前、后分别用套管针直接、弃血2ml后和常规方法同时静脉穿刺采血，分别抽取空腹及口服葡萄糖（75g）后30、60、120、180min的静脉血，用放射免疫分析法测定其血清胰岛素和C肽浓度。结果：①套管针直接采血法测定血清胰岛素和C肽浓度与空腹无显著性的差异（P＞0．05），糖负荷后各时相点均有显著性差异（P＜0．01）；试验组与对照组的糖负荷后胰岛素对数值有非常显著的相关性（P＜0．01），C肽对数值亦有显著的相关性（P＜0．05）。②套管针采血时先弃血2ml的新方法测定结果与对照组无显著性差异，试验组与对照组胰岛素及C肽对数值有显著的相关性（P＜0．01）。结论：套管针封管后再采血对胰岛素和C肽测定结果存在显著的差异，这种差异对病人诊治存在一定影响；而弃血2ml后采血对其测定结果无显著影响。

Effect of blood sampling with puncture trocar on insulin a nd C-peptid erelease test

Objective To study the effect of blood sampling with puncture trocar on insulin and C peptide release test. Methods In the experimental group (30 subjects), venous blood was drawn with puncture trocar after fast, and or taking after 2 ml blood disposal. 30, 60, 120 and 180 min after orally taking glucose (75 g). These patients also underwent blood sampling with routine venipuncture. Another 30 individuals served as control. The concentrations of insulin and C peptide in serum were measured with radioimmunoassay. Results With those 3 methods, there was no significant difference of the concentrations of insulin and C peptide in blood samples after fast ( P >0.05), but there were after orally taking glucose ( P <0.01). The logarithm values of insulin ( P < 0 01) and C peptide ( P < 0 05) after oral glucose were very significantly correlated between the experimental group and the controls( P < 0 01). Conclusion The puncture trocar itself has no effect on insulin and C peptide release test, but there exist certain differences with the other two blood sampling methods which may affect the diagnosis and treatment of the patients. Doctors and nurses should be careful when drawing blood with puncture trocar.