基于扫描式葡萄糖监测系统分析肝移植受者术后血糖变化情况  

Analysis of postoperative blood glucose variation in liver transplant recipients based on flash glucose monitoring system

作　　者：张利姗 于瑞[1] 叶海丹[1] Zhang Lishan;Yu Rui;Ye Haidan(The First Affiliated Hospital of Sun Yat-Sen University,Zhongshan,Guangdong 510080,China)

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《齐齐哈尔医学院学报》2024年第11期1089-1092,共4页Journal of Qiqihar Medical University

摘　　要：目的基于扫描式葡萄糖监测系统(FGM)分析肝移植受者术后血糖变化情况。方法选择2022年1月—2023年1月在本院行同种异体肝移植术的30例受者作为研究对象,应用FGM连续监测组织间液葡萄糖浓度,回顾性收集术后首日佩戴且满13 d非糖尿病受者的动态血糖监测数据图谱,包含空腹血糖、12个时间段血糖、预估糖化血红蛋白及每日葡萄糖平均值、目标范围内的时间、低于及高于目标范围内的时间,同时采集受者清晨空腹静脉血糖值。使用R语言软件进行Clarke误差分析及SPSS软件进行Pearson相关分析评价FGM的临床应用准确性。采用非参数秩和检验对比术后1~13 d的动态血糖变化情况。结果30例受者佩戴期间均未出现传感器脱离,平均佩戴时间(14.47±0.86)d,FGM血糖值(7.04±2.43)mmol/L,预估糖化血红蛋白(5.98±1.35)%,目标范围内时间(62.86±28.96)%,低于和高于目标范围内的时间分别为(9.87±16.05)%和(27.13±31.57)%。FGM佩戴期间共采集360对空腹FGM血糖值与静脉血糖值,Pearson相关分析结果示二者呈高度正相关(r=0.95,P<0.05)。Clarke误差分析结果示82%的血糖值落在A区,18%落在B区。不同术后天数在葡萄糖平均值及低于目标范围内的时间方面有差异(P<0.05),术后1~2 d血糖平均值最高,且低于目标范围内的时间均较其余术后时间短(P<0.05)。术后13 d内血糖呈下降趋势,不同时间段的血糖值有差异(P<0.05),每日0︰00~6︰00点血糖值为当日最低值(P<0.05)。服用免疫抑制剂后10︰00~12︰00点及22︰00~0︰00点血糖值均较服药前降低(P<0.05)。结论FGM应用于肝移植受者术后血糖监测准确性较高,术后早期易发生应激性高血糖,应注意及时调控血糖,避免发展成移植后糖尿病,增加并发症的发生。术后每日0︰00~8︰00点血糖值呈下降趋势,服用免疫抑制剂后10︰00~12︰00点及22︰00~0︰00点血糖值均较服药前降低。因此护理人员应密�Objective To analyze the changes of postoperative blood glucose in liver transplant recipients based on flash glucose monitoring system(FGM).Methods A total of 30 recipients undergoing allogeneic liver transplantation in our hospital from January 2022 to January 2023 were enrolled in the study.FGM was used to continuously monitor the glucose concentration of interstitial fluid.Continuous glucose monitoring map of non-diabetic patients,wearing FGM on the first day after operation and full of 13 days,were collected retrospectively.Including fasting plasma glucose,12-interval plasma glucose,glycated hemoglobin A1c,mean daily glucose,time in the target range,time below and above the target range,and fasting venous blood glucose values of recipients were collected.R software was used for Clarke error analysis and SPSS software was used for Pearson correlation analysis to evaluate the clinical application accuracy of FGM.Non-parametric rank sum test was used to compare the dynamic blood glucose changes from day 1 to day 13 after operation.Results No sensor disengagement occurred in 30 recipients during wearing.The average wearing time was(14.47±0.86)d,the FGM blood glucose value was(7.04±2.43)mmol/L,the estimated glycosylated hemoglobin was(5.98±1.35)%,and the time in the target range was(62.86±28.96)%.The time below and above the target range were(9.87±16.05)%and(27.13±31.57)%,respectively.A total of 360 pairs of fasting FGM blood glucose values and venous blood glucose values were collected during FGM wearing,and Pearson correlation analysis showed that the two were highly positively correlated(r=0.95,P<0.05).Clarke error analysis showed that 82%of the blood glucose values fell in zone A and 18%in zone B.There were differences in the mean glucose level and the time below the target range among different postoperative days(P<0.05).The mean glucose level was the highest in the first and second postoperative days,and the time below the target range was shorter than the other postoperative days(P<0.05).Within 13 da

关 键 词：肝移植 扫描式葡萄糖监测系统 血糖 

分 类 号：R657.3[医药卫生—外科学]