POCT血糖仪、生化仪葡萄糖氧化酶法和己糖激酶法检测新生儿血糖的研究

Study on Neonatal Blood Glucose Detected by POCT Glucose Meters and Biochemical Analyzer with Glucose Oxidase Method and Hexokinase Assay

目的从众多型号的POCT血糖仪中寻找与生化分析仪法相关性好的POCT血糖仪用来新生儿血糖的过筛和动态监测。方法模拟新生儿血液(高红细胞压积)检测:取高、中、低三种不同血糖浓度的成人患者样本各30人次,取静脉血用肝素抗凝,同一人次取3份。第一份用6个品牌8种型号血糖仪分别进行检测;第二份模仿新生血液、离心后吸去部分血浆,调红细胞压积至60%再用8款血糖仪分别进行检测;第三份用生化分析仪己糖激酶法检测。新生儿血液实例检测:取40例总胆红素正常新生儿和20例总胆红素升高的新生儿分别用强生稳步ONE Touch SureStep血糖仪检测毛细血管血糖,同时用生化分析仪(葡萄糖氧化酶法、己糖激酶法)检测静脉血的血糖。结果模拟新生儿血液的检测中:8款POCT血糖仪中,使用葡萄糖氧化酶光化学法原理的强生稳步ONE Touch Sure Step和罗氏ACCU-CHEK Active(机外进样)正常压积组A组和高红细胞压积组B组,高、中、低浓度血糖检测差异均无统计学意义(P>0.05),A组和B组与生化仪己糖激酶法有很好的相关性(r>0.95)。新生儿血液实例检测中:强生稳步血糖仪与生化仪葡萄糖氧化酶法和己糖激酶法检测结果差异均无统计学意义(P>0.05)。结论 POCT血糖仪葡萄糖氧化酶光化学法抗高红细胞压积的影响优于葡萄糖氧化酶电极法、葡萄糖脱氢酶电极法,使用葡萄糖氧化酶光化学法原理的POCT血糖仪与生化分析仪葡萄糖氧化酶法、己糖激酶法检测结果有很好的相关性,适合于新生儿血糖过筛和动态的监测。

Objective To find a good POCT glucose meter whose detection results could be well correlated with those by biochemical analyzer and could be used to measure and dynamically monitor the neonatal blood glucose. Methods In the detection of glucose of simulated neonatal blood （high hematocrit）, anticoagulant vein blood was collected from adult patients with hyperglycemia, normal blood glucose and hypoglycemia, 30 cases for each group and three portions for each sample of each patient. The glucose of the first potions （Group A） was detected by 8 blood glucose meters of 6 brands. The blood of the second potions （Group B） were processed to simulate neonate blood detection, that is, after centrifugation, part of the plasma was absorbed and the hematocrit was adjusted to 60%, and then the blood glucose was measured by the 8 blood glucose meters. The glucose of the third potions was measured by biochemical analyzer with hexokinase assay. In the glucose detection of neonatal blood, the glucose of capillary blood from 40 neonates with normal total bilirubin and 20 cases with elevated total bilirubin was detected by Johnson ＆ Johnson ONE Touch Sure Step Glucose Meter, and at the same time, the glucose of their venous blood was measured by biochemical analyzer with glucose oxidase method and hexokinase assay. Results In the detection of glucose of simulated neonatal blood, glucose detected by Johnson ＆ Johnson ONE Touch Sure Step and by Roche ACAEU - CHEK Active （machine injection） with glucose oxidase enzyme photochemical method did not show any significant difference for blood from patients with hyperglycemia, normal blood glucose and hypoglycemia in the Group A （normal hematocrit） and the Group B （high hematocrit） （P 〉 0.05）, and the detection results had a good correlation with the results by biochemical analyzer with hexokinase method （r 〉 0.95）. In the detection of neonatal blood, the test results by Johnson ＆ Johnson ONE Touch Sure Step and by biochemical analyzer with glucose oxidase method and hexokinase assay did not indicate significant difference （P〉0. 05）. Conclusions Concerning the capacity of the POCT glucose meters against the influence of high hematocrit, glucose oxidase photochemical method is better than the glucose oxidase electrode method and glucose dehydrogenase electrode method. Glucose detection results by POCT glucose meters with the glucose oxidase photochemical method have a good correlation with those by biochemical analyzer with glucose oxidase method and hexokinase assay. It is suitable for screening and dynamically monitoring of the neonatal blood glucose.