毛细血管与血清β-羟丁酸在儿科糖尿病酮症酸中毒中的比较。

Capillary versus Serum b-hydroxybutyrate in Pediatric Diabetic Ketoacidosis.

机构信息

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Correspondence to: Dr Rameshkumar R, Associate Professor, Division of Pediatric Critical care, Department of Pediatrics, (JIPMER), Puducherry 605 006, India.

出版信息

Indian Pediatr. 2019 Feb 15;56(2):126-129.

PMID:30819992

Abstract

OBJECTIVE

To find the strength of agreement between point-of-care and serum b-hydroxybutyrate.

METHODS

236 paired samples (capillary b-hydroxybutyrate by a point of care device and serum b-hydroxybutyrate by colorimetric enzymatic estimation) samples were collected from 26 children aged <13 years admitted with diabetic ketoacidosis. Inborn errors of metabolism and septic shock were excluded.

RESULTS

Capillary b-hydroxybutyrate showed excellent agreement with serum â-hydroxybutyrate with mean (SD) bias of 0.027 (0.78); 95% limit of agreement -1.51, 1.56 and intraclass correlation 96.1% (95%CI 95%-97%, P<0.001). An increase in the bias noted for value above 5 mmol/L (P<0.001) (serum measurements were higher than capillary point-of-care measure-ments). Capillary â-hydroxybutyrate correlated significantly with blood pH, anion gap,bicarbonate and carbon dioxide levels on blood gas analysis (P<0.05).

CONCLUSIONS

Capillary b-hydroxybutyrate estimation is a valid method for monitoring of ketonemia in pediatric diabetic ketoacidosis.

摘要

目的

寻找即时检测（point-of-care）与血清β-羟丁酸之间的一致性强度。

方法

从 26 名年龄<13 岁、因糖尿病酮症酸中毒入院的儿童中采集了 236 对（即时检测设备检测的毛细血管β-羟丁酸和比色酶法检测的血清β-羟丁酸）样本。排除了先天性代谢错误和感染性休克。

结果

毛细血管β-羟丁酸与血清β-羟丁酸具有极好的一致性，平均（SD）偏差为 0.027（0.78）；95%一致性界限-1.51，1.56 和组内相关系数 96.1%（95%CI 95%-97%，P<0.001）。在 5 mmol/L 以上的数值上，偏差增加（P<0.001）（血清测量值高于毛细血管即时检测测量值）。毛细血管β-羟丁酸与血气分析中的血 pH 值、阴离子间隙、碳酸氢盐和二氧化碳水平显著相关（P<0.05）。