动态血糖监测系统体内性能评估  

Evaluation of continuous glucose monitoring system in vivo

作　　者：李佳霖[1] 张敏[1] 李红[1] 童峰[2] 林薇[1] 管文军[3] 

机构地区：[1]浙江大学医学院附属邵逸夫医院内分泌科 [2]浙江大学医学院公共卫生系 [3]浙江大学生命科学院

出　　处：《浙江医学》2008年第9期920-922,935,共4页Zhejiang Medical Journal

基　　金：浙江省科技厅资助项目(2004C33008)

摘　　要：目的评价动态血糖监测系统(CGMS)在体内持续血糖监测中的精确性及对低血糖的诊断价值。方法采用CGMS对5只正常SD大鼠行连续血糖监测,使用50%葡萄糖注射液或胰岛素模拟高血糖或低血糖过程,以同期尾静脉全血血糖作参照。分析CGMS与参照血糖仪测量血糖间的一致性;比较CGMS与参照血糖仪对低血糖诊断一致性。结果⑴CGMS与参照血糖仪测量值第1天与第2天内相关系数分别为0.70与0.87,总相关系数0.82。第1天与第2天内平均相对差异分别为15.8%和19.8%,总平均相对差异17.8%;⑵尾静脉血糖与CGMS血糖差值的几何均数为1.031,血糖仪测量值与CGMS血糖的比值95%一致性范围(0.65,1.62);⑶CGMS和血糖仪测量值之间的相对差异与血糖水平存在正相关(列联系数=0.314);⑷CGMS与参照血糖仪对低血糖诊断一致性Kappa=0.603(P<0.01)。结论CGMS的精确性仍有待于进一步提高,临床医生尚不能完全根据CGMS监测结果来指导临床用药。Objective To evaluate the accuracy, reliability of continuous glucose monitoring system （CGMS） in vivo. Methods Five SD rats underwent glucose monitoring by CGMS; blood samples were taken from vena caudalis and blood glucose was also measured by Onetouch Surestep analyzer as reference. Hyperglycemia and hypoglycemia were induced by injecting 50% glucose solution and insulin, respectively. The results from CGMS were compared with those from reference method. Results The intraday correlation coefficient between CGMS and reference method at dl and d2 was 0.70 and 0.87, with total correlation coefficients of 0.82. The intraday mean relative error at dl and d2 was 15.8% and 19.8% with total mean relative error of 17.8%. The geometric mean value of difference between two methods was 1.03 （95% CI 0.65-1.62）, The difference between two methods was correlated with the blood glucose levels, and the coefficient of continency was 0.314. The Kappa value of CGMS to detects hypoglycemia was 0.603 （P〈0.01）. Conclusion The accuracy of CGMS remains to be improved. It may not replace conventional blood glucose measurement in clinical practice.

关 键 词：动态血糖监测系统 体内性能评估 临床用药 监测方法 

分 类 号：R587.1[医药卫生—内分泌]