微量血糖仪在快速诊断新生儿低血糖中的应用价值  

Application of trace glucose meter in the rapid diagnosis of neonatal hypoglycemia

作　　者：徐洪涛[1] 余健[1] 聂国明 邹敏书[1] 罗莉漫[1] 杨新凤[1] 田浩[1] 

机构地区：[1]广州军区武汉总医院儿科,武汉市430070

出　　处：《实用医学杂志》2011年第14期2542-2544,共3页The Journal of Practical Medicine

摘　　要：目的:评价微量血糖仪在快速诊断新生儿低血糖中的应用价值。方法:对725例新生儿同时采用微量血糖仪纸片法测定毛细血管全血血糖水平和生化室己糖激酶法测定静脉血浆血糖水平,微量血糖仪纸片法全血血糖<2.2mmol/L和生化室己糖激酶法血浆血糖<2.6mmol/L为各自诊断新生儿低血糖的标准,以生化室己糖激酶法血浆血糖<2.6mmol/L为金标准,采用Yerushalmy四格表评价模式,计算敏感度、特异度、准确度、阳性似然比和阴性似然比。结果:微量血糖仪纸片法诊断新生儿低血糖敏感度欠佳(56.0%),特异度高(99.2%)。结论:微量血糖仪纸片法在诊断新生儿低血糖时误诊率极低,但可能会漏诊,可考虑适当提高诊断阈值来降低漏诊率。Objective The aim of this study were to evaluate the value of trace glucose meter in the rapid diagnosis of neonatal hypoglycemia. Methods Seven hundred and twenty-five newborns were recruited into the study. Glucose levels were measured simultaneously by the trace glucose meter in capillary blood using glucose oxidase and by an accepted clinical laboratory method in hematoplasma using hexokinase. The diagnostic standard of neonatal hypoglycemia was that capillary blood glucose value was below 2.2 mmol/L or hematoplasma blood glucose value was below 2.6 mmol/L. However, the hematoplasma blood glucose value detected below 2.6 mmol/L by an accepted clinical laboratory method using hexokinase was considered as the gold standard. The sensitivity, specificity, accuracy, and positive and negative likelihood ratio of trace glucose meter were evaluated with Yerushalmy mode. Results Trace glucose meter displays poor sensitivity（56.0%）, but high specificity （99.2%） in the diagnosis of neonatal hypoglycemia. Conclusion The misdiagnosis rate of trace glucose meter was very low, but the rate of missed diagnosis was not enough low. So it should be considered that elevating the diagnostic threshold appropriately to reduce the rate of missed diagnosis.

关 键 词：低血糖症 微量血糖仪 快速诊断 

分 类 号：R722.1[医药卫生—儿科]