D'Orazio Paul, Burnett Robert W, Fogh-Andersen Niels, Jacobs Ellis, Kuwa Katsuhiko, Külpmann Wolf R, Larsson Lasse, Lewenstam Andrzej, Maas Anton H J, Mager Gerhard, Naskalski Jerzy W, Okorodudu Anthony O
Instrumetation Laboratory, Lexington, MA, USA.
Clin Chem. 2005 Sep;51(9):1573-6. doi: 10.1373/clinchem.2005.051979.
In current clinical practice, plasma and blood glucose are used interchangeably with a consequent risk of clinical misinterpretation. In human blood, glucose, like water, is distributed between erythrocytes and plasma. The molality of glucose (amount of glucose per unit of water mass) is the same throughout the sample, but the concentration is higher in plasma because the concentration of water and, therefore, glucose is higher in plasma than in erythrocytes. Different devices for the measurement of glucose may detect and report fundamentally different quantities. Different water concentrations in calibrators, plasma, and erythrocyte fluid can explain some of the differences. Results of glucose measurements depend on sample type and on whether methods require sample dilution or use biosensors in undiluted samples. If the results are mixed up or used indiscriminately, the differences may exceed the maximum allowable error of glucose determinations for diagnosing and monitoring diabetes mellitus, and complicate the treatment. The goal of the IFCC Scientific Division Working Group on Selective Electrodes and Point of Care Testing (IFCC-SD, WG-SEPOCT) is to reach a global consensus on reporting results. The document recommends reporting the concentration of glucose in plasma (with the unit mmol/L), irrespective of sample type or measurement technique. A constant factor of 1.11 is used to convert concentration in whole blood to the equivalent concentration in the pertinent plasma. The conversion will provide harmonized results, facilitating the classification and care of patients and leading to fewer therapeutic misjudgments.
在当前临床实践中,血浆葡萄糖和血糖被交替使用,从而存在临床误解的风险。在人体血液中,葡萄糖像水一样,分布于红细胞和血浆之间。葡萄糖的质量摩尔浓度(每单位水质量中的葡萄糖量)在整个样本中是相同的,但血浆中的浓度更高,因为血浆中的水浓度,进而葡萄糖浓度高于红细胞。不同的葡萄糖测量设备可能检测并报告根本不同的量。校准液、血浆和红细胞液中不同的水浓度可以解释其中一些差异。葡萄糖测量结果取决于样本类型以及方法是否需要样本稀释或在未稀释样本中使用生物传感器。如果结果混淆或被随意使用,差异可能超过诊断和监测糖尿病时葡萄糖测定的最大允许误差,并使治疗复杂化。国际临床化学和检验医学联合会(IFCC)科学部选择性电极与即时检验工作组(IFCC-SD,WG-SEPOCT)的目标是就结果报告达成全球共识。该文件建议报告血浆中葡萄糖的浓度(单位为mmol/L),而不考虑样本类型或测量技术。使用常数1.11将全血中的浓度转换为相应血浆中的等效浓度。这种转换将提供统一的结果,便于对患者进行分类和护理,并减少治疗判断失误。