维持性血液透析患者透析中血糖仪床旁全血血糖检测法准确度研究

Accuracy study of glucose meter bedside whole blood glucose measurement in maintenance hemodialysis patients during dialysis

目的验证在维持性血液透析患者透析中,应用血糖仪行床旁全血血糖检测所得值的准确度。方法选择2019年6月至2020年2月在上海交通大学医学院附属仁济医院维持性血液透析患者120例,其中男性60例,女性60例;年龄20~86岁,平均年龄62.23岁(标准差13.14岁)。于患者上机后3 min内经血管通路采样进行血糖检测。分别采用血糖仪床旁全血血糖检测法和实验室生化血浆血糖检测法,测量血糖值。检验其Spearman相关性和组内相关系数(ICC)一致性结果。并根据患者原发病种类、有无降糖治疗、血管通路类型分组,分析组间血糖值的相关性和一致性。结果血糖仪床旁全血血糖检测值为(6.265±2.597)mmol/L,实验室生化血浆血糖检测值为(5.755±2.361)mmol/L。两种检测方法所得血糖值的相关性良好(r=0.881,P<0.01),且ICC一致性分析显示两者一致性好(ICC=0.945,P<0.01)。根据原发病种类、有无降糖治疗、血管通路类型不同因素分组,两种检测方法所获血糖值的相关性和一致性均较高。结论血糖仪床旁全血血糖检测法所测得血糖值较为准确地反映患者的血糖水平,可信度较高,有利于准确判断患者的血糖临界或高低状况,可以采纳作为透析中血糖检测方法。

Objective To verify glucose detection value accuracy by glucose meter bedside whole blood glucose in maintenance hemodialysis patients during dialysis.Method From June 2019 to February 2020,120 maintenance hemodialysis patients were enrolled,which included 60 males and 60 females,aged 20-86 years old with mean age of 62.23 years old(standard deviation 13.14 years old).The blood glucose testing was performed via vascular access sampling within 3-minute after patient using machine.The blood glucose values were measured by glucose meter bedside whole blood glucose method and laboratory biochemical plasma blood glucose,respectively.The consistency results of Spearman correlation and intraclass correlation coefficient(ICC)were detected.All of them were grouped by pathogenesis,hypoglycemic treatment,vascular access type,the inter-group blood glucose value correlation and consistency was analyzed.Results The blood glucose detection value of glucose meter bedside whole blood glucose was(6.265±2.597)mmol/L and laboratory biochemical plasma blood glucose was(5.755±2.361)mmol/L.Two detection methods showed good correlation of blood glycans(R=0.881,P<0.01),and ICC analysis also indicated the good consistency of different groups(ICC=0.945,P<0.01).The correlation and consistency of blood glucose values of 2 detection methods were high when grouped by primary disease type,hypoglycemic treatment and vascular access type.Conclusion It is demonstrated that glucose meter bedside whole blood glucose measurement accurately reflects blood glucose of patients with credibility,which is conducive to accurate judgment critical,high or low,and could be used as the blood glucose detection method during dialysis.