Holtrop P C, Madison K A, Kiechle F L, Karcher R E, Batton D G
Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI 48072.
Am J Dis Child. 1990 Feb;144(2):183-5. doi: 10.1001/archpedi.1990.02150260063029.
Although glucose oxidase-peroxidase chromogen test strips are frequently used to estimate serum glucose values in newborns, previous studies have not evaluated multiobserver variability of test strip readings and have included few infants with hypoglycemia. We compared values of 272 samples of serum glucose with values simultaneously obtained by chromogen test strips (Chemstrip bG) in newborns. The diagnostic sensitivity of a chromogen test strip less than 2.2 mmol/L for predicting a serum glucose level less than 1.9 mmol/L was 86% (95% confidence interval [CI], 75% to 94%), with 78% specificity (95% CI, 73% to 84%). The positive predictive value in our specimens, with a 21% prevalence of serum glucose levels less than 1.9 mmol/L, was 52% (95% CI, 41% to 62%), with a negative predictive value of 95% (95% CI, 91% to 100%). Fifty-eight of our serum glucose values were less than 1.9 mmol/L and the levels obtained by chromogen test strip were greater than or equal to 2.2 mmol/L in 8 of these cases. Review of these 8 cases showed that a delay in performing the laboratory glucose oxidase serum glucose could account for the discrepancy in 2 cases. Chromogen test strips are readily available and easy to use, but more sensitive, specific, accurate, and precise methods of serum glucose screening in newborns are needed.
尽管葡萄糖氧化酶-过氧化物酶色原试纸常被用于估算新生儿的血清葡萄糖值，但以往的研究并未评估试纸读数的多观察者变异性，且纳入的低血糖婴儿较少。我们将272份新生儿血清葡萄糖样本的值与同时用色原试纸（Chemstrip bG）测得的值进行了比较。色原试纸检测值小于2.2 mmol/L用于预测血清葡萄糖水平小于1.9 mmol/L的诊断敏感性为86%（95%置信区间[CI]，75%至94%），特异性为78%（95% CI，73%至84%）。在我们的样本中，血清葡萄糖水平小于1.9 mmol/L的患病率为21%，其阳性预测值为52%（95% CI，41%至62%），阴性预测值为95%（95% CI，91%至100%）。我们的血清葡萄糖值中有58个小于1.9 mmol/L，其中8例通过色原试纸测得的值大于或等于2.2 mmol/L。对这8例病例的复查表明，实验室葡萄糖氧化酶法检测血清葡萄糖的延迟可能导致了其中2例的差异。色原试纸容易获得且使用方便，但仍需要更敏感、特异、准确和精确的新生儿血清葡萄糖筛查方法。
