电子血糖分析仪用于新生儿低血糖床旁测定可能不十分可靠

作     者：Rosenthal M. Ugele B. Lipowsky G. Küster H. 刘莉 

作者机构：Department for Neonatology and Pediatric Intensive Care University Children's Hospital Soldtmannstr. 15 17487 Greifswald Germany 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第6期

页      面：19-19页

学科分类：1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：新生儿低血糖 血糖测定值 床旁检测 分析仪 0.6mmol/L 电子 实验室方法 实验室检查方法 足月新生儿 前瞻性观察 

摘      要：The aim of this prospective observational study was to compare a bedside test with the reference laboratory method in routine postnatal glucose monitoring. Term newborns with increased risk or clinical signs of hypoglycemia were screened with a bedside test. In case of a glucose value below 2.25 mmolL, a second blood sample was taken and a duplicate glucose measurement done in the laboratory using a bedside test (Accutrend sensor) and the reference laboratorymethod (hexokinase method) at the same time and from the same sample. From 110 term newborns, 122 blood samples were obtained for duplicate measurements (median 1.69 mmolL, SD 0.45 mmolL). Of these 122, Accutrend correctly identified 97%as being 2.25 mmolL by the laboratory method. A Bland-Altman plot revealed a mean underestimation of the Accutrend of only-0.09 mmolL. However, due to high scattering, the maximal over-and underestimation was 0.89 and 1.39 mmolL, respectively. Only 75%of the results from the Accutrend were within ±20%of the result of the laboratory method. If the cutoff for low glucose concentrations was set 0.6 mmolL higher for the bedside test as compared to the laboratory method, all patients except one would have been correctly identified as hypoglycemic. Conclusion: When using the Accutrend sensor, single infants with even marked hypoglycemia might be missed. Some delay in receiving accurate measurements might be more helpful for clinical decisions and long-term outcome than immediate but potentially misleading results.