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[因血样保存不当导致“新生儿低血糖症”的错误诊断]

[Erroneous diagnosis 'neonatal hypoglycemia' due to incorrect preservation of blood samples].

作者信息

Joosten K F, Schellekens A P, Waelkens J J, Wulffraat N M

机构信息

Afd. Kindergeneeskunde, Catharina Ziekenhuis, Eindhoven.

出版信息

Ned Tijdschr Geneeskd. 1991 Sep 14;135(37):1691-4.

PMID:1922513
Abstract

The high frequency of neonatal hypoglycaemia found in the St. Catherine's Hospital, Eindhoven [corrected], (8.2% of all newborn infants had values of 1.8 mmol/l glucose or less) promoted us to test the effects of the different conditions of blood preservation before measuring in a consecutive series of 18 newborn infants at risk for hypoglycaemia. When blood was preserved in microtest tubes coated with sodium fluoride (NaF) and measured after 1 hour at room temperature, the glucose level decreased by 7 to 36%. Storage on melting ice for one hour prevented this decline completely. In our hospital sodium fluoride coated microtest tubes are used. They were found to contain various concentrations of NaF, ranging from 0.85 to 2.65 mg/ml. In a 2nd experiment with cord blood from 8 patients, we proved that a concentration of 16 mg/ml sodium fluoride was necessary to inhibit glycolysis and to prevent a fall of plasma glucose. The rapid determination of blood glucose values, i.e. within 10 minutes after the blood sample is taken, decreased, as expected, the frequency of hypoglycaemia in the newborn at risk.

摘要

在埃因霍温的圣凯瑟琳医院(已修正)发现新生儿低血糖的发生率很高(所有新生儿中有8.2%的血糖值为1.8 mmol/l或更低),这促使我们在连续的18名有低血糖风险的新生儿中测试不同血液保存条件对测量结果的影响。当血液保存在涂有氟化钠(NaF)的微量试管中,并在室温下放置1小时后测量时,血糖水平下降了7%至36%。在冰上融化保存1小时可完全防止这种下降。在我们医院使用的是涂有氟化钠的微量试管。发现这些试管中含有各种浓度的NaF,范围从0.85至2.65 mg/ml。在第二个实验中,我们使用8名患者的脐带血证明,需要16 mg/ml的氟化钠浓度来抑制糖酵解并防止血浆葡萄糖下降。如预期的那样,快速测定血糖值,即在采集血样后10分钟内完成测定,降低了有风险的新生儿低血糖的发生率。

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