动态血糖监测系统测定组织间液糖浓度与血糖变化时间的差异

Time difference in dynamic glucose concentrations between interstitial fluid and peripheral blood

目的比较动态血糖监测系统（CGMS）测得的组织间液糖浓度与末梢静脉血血糖的动态变化过程，初步探讨两者间可能存在的时间差异。方法采用CGMS对4只正常SD大鼠行连续（458±44）h组织间液葡萄糖监测，使用50％葡萄糖注射液行腹腔注射模拟高血糖过程，优泌林R尾静脉注射模拟低血糖状态，并同期测定尾静脉全血血糖。采用最小二乘法拟合血糖／电流一时间曲线，以拟合曲线函数的一阶导数确定高血糖过程中葡萄糖上升最快、达峰和回降最快的时间点，以及低血糖阶段葡萄糖下降最快、达谷和回升最快的时间点，比较CGMS与末梢静脉血葡萄糖达到不同时间点所需的时间差异。结果糖负荷后末梢静脉血血糖上升最快时间为（5．15±4．80）min，先于CGMS的（21．1±6．29）min（P〈005），而达峰时间、回降最快时间无统计学差异。胰岛素注射后的低血糖过程时间差均无统计学意义。结论CGMS测得的组织间液葡萄糖浓度变化与血糖变化间存在时间差异。

Objective To determine the time differences in dynamic glucose concentrations between interstitial fluid and peripheral blood. Methods Four normal SD rats underwent glucose monitoring by the continuous glucose monitoring system （ CGMS ）for （ 45.8 ± 4.4）h, whole blood glucose levels from vena caudalis were measured simultaneously by Onetouch Surestep analyzer. Hyperglycemia was simulated by injecting 50% glucose solution, and hypoglycemia was induced by injecting insulin. Smoothing algorithms using a least squares method was applied to the glucose or current time curves. The first derivatives of the curves were used to define the fast rising and falling time, and the time to reach peak and nadir. Time differences between CGMS and blood glucose were analyzed at these time points. Results After glucose load, peripheral blood glucose levels were rising in （5.15 ± 4.80）min,which was faster than that measured by CGMS （21.1 ± 6.29）min （P〈0.05）.There were no significant differences in time of reaching the peak and falling, and in the procedure of insulin-induced hypoglycemia between interstitial glucose and blood glucose. Conclusion There are time differences between interstitial glucose levels measured by CGMS and peripheral blood glucose levels measured by Onetouch Surestep analyzer.