Floré Katelijne M J, Delanghe Joris R
Department of Clinical Chemistry, University Hospital Ghent, Belgium.
Perit Dial Int. 2009 Jul-Aug;29(4):377-83.
Current point-of-care testing (POCT) glucometers are based on various test principles. Two major method groups dominate the market: glucose oxidase-based systems and glucose dehydrogenase-based systems using pyrroloquinoline quinone (GDH-PQQ) as a cofactor. The GDH-PQQ-based glucometers are replacing the older glucose oxidase-based systems because of their lower sensitivity for oxygen. On the other hand, the GDH-PQQ test method results in falsely elevated blood glucose levels in peritoneal dialysis patients receiving solutions containing icodextrin (e.g., Extraneal; Baxter, Brussels, Belgium). Icodextrin is metabolized in the systemic circulation into different glucose polymers, but mainly maltose, which interferes with the GDH-PQQ-based method. Clinicians should be aware of this analytical interference. The POCT glucometers based on the GDH-PQQ method should preferably not be used in this high-risk population and POCT glucose results inconsistent with clinical suspicion of hypoglycemic coma should be retested with another testing system.
当前的即时检验（POCT）血糖仪基于多种检测原理。两个主要方法组主导着市场：基于葡萄糖氧化酶的系统和以吡咯喹啉醌（GDH-PQQ）作为辅因子的基于葡萄糖脱氢酶的系统。基于GDH-PQQ的血糖仪因其对氧气的较低敏感性正在取代较旧的基于葡萄糖氧化酶的系统。另一方面，GDH-PQQ检测方法在接受含艾考糊精溶液（如Extraneal；百特公司，比利时布鲁塞尔）的腹膜透析患者中会导致血糖水平假性升高。艾考糊精在体循环中代谢为不同的葡萄糖聚合物，但主要是麦芽糖，这会干扰基于GDH-PQQ的方法。临床医生应意识到这种分析干扰。基于GDH-PQQ方法的POCT血糖仪最好不要用于这个高风险人群，并且与低血糖昏迷临床怀疑结果不一致的POCT血糖结果应用另一种检测系统重新检测。
