人体体质成分及血清生化指标对瞬感扫描式动态血糖监测仪准确性的影响研究  

Effect of Human Body Composition and Serum Biochemical Indicators on the Accuracy of Flash Glucose Monitoring System

作　　者：楚晓婧[1] 李俊[1] 付艳芹[1] 刘丹青 刘爱萍[1] 张园园 CHU Xiaojing;LI Jun;FU Yanqin;LIU Danqing;LIU Aiping;ZHANG Yuanyuan(Department of Endocrinology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院内分泌科,河南省郑州市450014

出　　处：《中国全科医学》2023年第35期4433-4438,共6页Chinese General Practice

基　　金：河南省医学科技攻关计划项目(LHGJ20190328)。

摘　　要：背景瞬感扫描式葡萄糖监测系统(FGM)临床应用越来越广泛,其佩戴期间不需指尖血校正,可持续监测14 d,并以此为基础为临床治疗提供依据。因此,其准确性显得尤为重要。目的探讨人体体质成分及血清生化指标对FGM传感器精度的影响。方法选择2022年在郑州大学第二附属医院内分泌科住院的2型糖尿病(T2DM)患者作为研究对象,通过电子病历系统收集患者的一般资料。采用FGM检测患者血糖数据,并与静脉血糖进行对比,收集患者的体质分析数据。采集患者空腹静脉血分析血液学参数。运用Clarke误差栅格分析法评价FGM临床准确度。依据配对血糖平均绝对相对误差值(MARD)将患者分为准确组(MARD<10%,n=23)和不准确组(MARD>20%,n=34)。采用二元Logistic回归分析探讨FGM准确性的影响因素。结果共收集了694对血糖数据,以静脉血糖作为参考值,对FGM扫描血糖值进行Clarke误差栅格分析,结果显示82.9%落在临床准确区(A区),16.9%落在临床可接受区(B区),99.8%落在A+B区,0.2%落在临床错误区(D区),平均MARD为12.7%。不准确组患者MARD、肌肉量高于准确组,尿酸、体脂量、脂肪百分比低于准确组(P<0.05)。男性不准确组患者尿酸、体脂量、脂肪百分比低于准确组,MARD、肌肉量高于准确组(P<0.05);女性不准确组患者MARD高于准确组(P<0.05)。二元Logistic回归分析结果显示,肌肉量、尿酸水平是FGM准确性的影响因素(P<0.05)。结论FGM整体准确性符合国际标准。FGM传感器精度与尿酸水平及人体肌肉量有关,但不受血液中电解质离子及其他生化指标的影响,同时也不受人体水分、体脂含量、无机盐含量及传感器佩戴部位的脂肪厚度等因素的干扰。Background The clinical application of flash glucose monitoring system(FGM)is becoming increasingly widespread,which can be continuously monitored for 14 days and does not require fingertip blood correction during wearing,providing a basis for clinical treatment.Therefore,the accuracy of FGM is particularly important.Objective To investigate the effect of human body composition and serum biochemical indicators on the accuracy of FGM sensor.Methods Patients with type 2 diabetes mellitus(T2DM)hospitalized in the Department of Endocrinology of the Second Affiliated Hospital of Zhengzhou University in 2022 were selected as the study objects,and their general data was collected through the electronic medical record system.The blood glucose was detected by FGM and compared with intravenous blood glucose,the physical analysis data of patients was collected.Fasting venous blood was collected to analyze hematological parameters.The clinical accuracy of FGM was evaluated by Clarke error grid analysis.The included patients were divided into the accurate group(MARD<10%,n=23)and inaccurate group(MARD>20%,n=34)according to the matched mean absolute relative difference of blood glucose(MARD).Binary Logistic regression analysis was used to analyze the influencing factors of FGM accuracy.Results A total of 694 pairs of blood glucose data were collected.Clarke error grid analysis was performed on the blood glucose values of FGM scans using venous blood glucose as the reference value.The results showed that 82.9%fell in zone A,16.9%fell in zone B,99.8%fell in zone A+B,and 0.2%fell in zone D,with an average MARD of 12.7%.MARD and muscle mass in the inaccurate group were higher than those in the accurate group(P<0.05),while uric acid,body fat mass and fat percentage were lower than those in the accurate group(P<0.05).Uric acid,body fat mass and fat percentage of male patients in the inaccurate group were lower than those in the accurate group,while the MARD value and muscle mass of male patients were higher than those in the accurate

关 键 词：糖尿病 2型 血液化学分析 血糖自我监测 瞬感扫描式葡萄糖监测系统 影响因素分析 

分 类 号：R587.1[医药卫生—内分泌]