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。

Reliability of Forearm CGA during Hypoglycemia Reaction among Diabetes Patients

Objective To study the correlation between CGA, CGF and VG during hypoglycemia reaction among diabetes patients. Methods 34 diabetes patients at compulsory treatment from July to November, 2006, involved the study. At hypoglycemia reaction, and 20 minutes after taking 50% glucose, the venous blood was drawn by one experienced nurse for prompt determination of VG with autoanalyzer and for CGA and CGF tests by another nurse with Free Style glucose monitor. Results At hypoglycemia reaction, CGA [（4.04±0.68）mmol/L] was significantly higher than CGF[（2.85±0.22）mmol/L] and VG[（2.64±0.21）mmol/L] statistically （P〈0.001）. 20 minutes after orally taking 50% glucose, CGA[（7.03±1.20）mmol/L] was significantly lower than CGF[（9.15±1.69）mmol/L] and YG [（9.27±1.70）mmol/L] statistically （P〈0.001）. The correlation analysis showed r=0.616 and 0.983 in the time of hypoglycemia reaction and 20 minutes after taking glucose between CGF and VG, respectively （P〈0.001）. Conclusion At hypoglucemia reaction, it is appropriate to test CGF and VG rather than CGA.