快速血糖仪与生化仪测定血糖结果比较的系统评价

Systematic Review of Blood Glucose Determined by Glucose Meter and Autoanalyzer

目的系统评价快速血糖仪与生化仪测定血糖结果的差异性。方法计算机检索MEDLINE、CNKI、FMJS和CBM等数据库,检索年限为1995～2008年5月。收集关于快速血糖仪与生化仪测定血糖结果比较的诊断性试验,进行质量评价后,采用RevMan软件进行Meta分析。结果最终纳入24篇文献,共4963例患者,其中中文15篇、英文9篇。Meta分析结果显示:国外研究中,雅培、罗氏和强生快速血糖仪患者血糖测定值均较生化仪高,其WMD(95%CI)分别为0.57(0.34,0.80)、0.43(0.04,0.81)和0.41(0.11,0.71);而国内研究中,雅培和罗氏快速血糖仪组血糖测定值与生化仪组差异无统计学意义[WMD=0.60,95%(-0.79,1.99);WMD=-0.13,95%(-0.56,0.29)],强生快速血糖仪组血糖测定值低于生化仪组,其差异有统计学意义[WMD=-0.95,95%(-1.42,-0.48)]。结论对于雅培、罗氏和强生快速血糖仪,国外研究结果较一致,其血糖测定值均高于生化仪;而国内研究因影响因素较多,差异较大,其血糖测定正常参考值范围需根据各医院情况进行调整。由于部分亚组纳入研究和样本数较少,且研究质量普遍不高,上述结论尚需开展更多高质量研究进一步验证。

Objective To assess the differences between a glucose meter and autoanalyzer at home and broad. Method MEDLINE, CNKI, FMJS, and CBM were searched electronically （1995 to May, 2008）. The statistical analysis of included studies was performed according to the Cochrane systematic reviews method. Result Twenty four studies, including 11 English records and 19 Chinese records involving 4 963 specimens, were included in this study. Meta-analysis showed us the blood glucose values of Abbott, Roche, and Johnson abroad subgroups are higher than the laboratory method, and their WMD （95%CI） are 0.57 （0.34,0.80）, 0.43 （0.04,0.81）, 0.41 （0.11,0.71）. The blood glucose values of the Abbot and Roche domestic subgroups are comparable to the laboratory method [WMD= 0.60, 95%CI （-0.79, 1.99）; WMD= -0.13, 95%CI （-0.56, 0.29）]. The blood glucose value of the Johnson domestic subgroup is lower than laboratory method [WMD= -0.95, 95%CI （-1.42, -0.48）]. Conclusion The results of the abroad studies are relatively consistent, and the blood glucose values of all abroad subgroups are higher than laboratory method. The domestic studies are different because of other factors.