第1和第2滴手指末梢血与静脉血血糖值的比较分析

Comparison of capillary blood glucose from the 1 st and 2 nd drop of blood drawn from the finger with venous blood glucose

目的探讨第1滴和第2滴手指末梢血与患者静脉血糖值的差异,为临床采集末梢血测定血糖提供参考。方法测定210例住院患者的空腹血糖,分别将手指末梢第1滴、第2滴血糖检测值与静脉血血糖值进行比较。结果血糖浓度分层统计结果显示,当静脉血血糖值2.2~7.0 mmol/L时,末梢第1滴血、第2滴血的血糖值显著高于静脉血血糖值(P<0.05,P<0.01);当静脉血血糖值>7.0 mmol/L时,末梢血与静脉血的血糖值差异无统计学意义(P>0.05)。整体组间比较,末梢第2滴血与静脉血血糖值比较差异有统计学意义(P<0.01)。Bland-Altman分析结果显示,第1滴、第2滴血与静脉生化血糖检测结果、末梢第2滴血与末梢第1滴血检测结果之间显著相关(均P<0.01);末梢第1滴血与静脉血糖检测结果的一致性较高。结论使用便携式血糖仪监测血糖时,若按正规操作,可以使用第1滴末梢血检测血糖值,当血糖值>7.0 mmol/L时,末梢第1滴血与第2滴血均可反映即时静脉血糖值。

Objective To compare capillary blood glucose from the 1st and 2nd drop of blood drawn from the finger with venous blood glucose,and to provide reference for capillary blood glucose measurement in clinical settings.Methods The fasting blood glucose concetrations of 210 hospitalized patients were measured and compared in the following way:the patients had a finger puncture and the 1st and 2nd drop of blood were harvested seperately to obtain capillary blood glucose concetrations,which were later compared with venous blood glucose respectively.Results The results of stratified statistical analysis on blood glucose showed that:venous blood glucose values between 2.2-7.0 mmol/L were significantly lower than capillary blood glucose from either the 1st or 2nd drop of blood(P<0.05,P<0.01);venous blood glucose values>7.0 mmol/L had no significant differences with either type of capillary blood glucose(P>0.05 for all);overall capillary blood glucose from the 2nd drop of blood had significant differences with venous blood glucose(P<0.01).Bland-Altman analysis showed that there were significant correlations between each pair of blood glucose types(1st drop vs.venous,2nd drop vs.venous,1st drop vs.2nd drop,P<0.01 for all);there was higher consistency between 1st drop vs.venous blood glucose.Conclusion In the case of using portable glucose meter to monitor blood sugar,capillary blood glucose from the 1st drop of blood,if appropriately harvested,can represent blood glucose levels.Attention should be noted that in the context of the blood sugar greater than 7.0 mmol/L,capillary blood glucose from either the 1st or 2nd drop of blood can represent instant venous blood glucose values.