Leal Sandra, Soto-Rowen Marisa
Association of Clinicians for Underserved, El Rio Health Center, Tucson, Arizona 85745, USA.
J Diabetes Sci Technol. 2009 Jul 1;3(4):672-6. doi: 10.1177/193229680900300409.
The purpose of this article was to communicate our experience with point-of-care testing (POCT) using Bayer's A1CNow+ device to test glycated hemoglobin (A1C) in the management of diabetes and to share the observations of our quality control efforts.
Forty-seven patients' POCT samples were compared with laboratory samples to determine the validity of the POCT sample being drawn. Data collected represent a 10-month time period that were drawn on-site with the following distribution: 36 samples were drawn the same day, 7 samples were drawn 1 day later, 3 samples were drawn within 3 days, and 1 sample was drawn 4 days later. Although all samples were collected on-site, some of the samples were sent to other local branches of nationally recognized laboratories for analysis.
The range of A1C results for the POCT group was 5.6 to >13%. The range of A1C results for the laboratory-drawn group was 5 to 12.6%. Twenty-four patients had laboratory results that read lower than the result obtained in the clinic, with an A1C range of 5 to 12.6%, and two patients had laboratory results that read exactly the same as the result obtained in the clinic when using POCT. These two individuals had A1C results of 9.1 and 12.6%. Analysis of data collected determined an r value of 0.918 demonstrating agreement between the POCT samples and the laboratory samples.
POCT with the A1CNow+ is an effective, economical tool for use in a pharmacist-based diabetes clinic that serves a high-risk underserved population. POCT allows the pharmacist the ability to use on-site results to inform patients of their progress, modify their therapy immediately with an immediate face-to-face opportunity to assure understanding, and provide a self-management goal.
本文旨在分享我们使用拜耳A1CNow+设备进行即时检验（POCT）以检测糖化血红蛋白（A1C）在糖尿病管理中的经验，并分享我们质量控制工作的观察结果。
将47例患者的POCT样本与实验室样本进行比较，以确定所采集的POCT样本的有效性。收集的数据代表了10个月的时间段，这些样本在现场采集，分布如下：36个样本在同一天采集，7个样本在1天后采集，3个样本在3天内采集，1个样本在4天后采集。尽管所有样本均在现场采集，但部分样本被送往全国认可实验室的其他当地分支机构进行分析。
POCT组的A1C结果范围为5.6%至>13%。实验室采集组的A1C结果范围为5%至12.6%。24例患者的实验室结果低于临床获得的结果，A1C范围为5%至12.6%，2例患者在使用POCT时的实验室结果与临床获得的结果完全相同。这两人的A1C结果分别为9.1%和12.6%。对收集的数据进行分析，确定r值为0.918，表明POCT样本与实验室样本之间具有一致性。
使用A1CNow+进行POCT是一种有效、经济的工具，可用于为高危、服务不足人群提供服务的以药剂师为主导的糖尿病诊所。POCT使药剂师能够利用现场结果告知患者其病情进展，立即调整治疗方案，并通过即时面对面的机会确保患者理解，同时提供自我管理目标。
