Ting C, Nanji A A
University of Ottawa, Ont.
CMAJ. 1988 Jan 1;138(1):23-6.
We evaluated the precision and accuracy of monitoring of the blood glucose level in the laboratory and at the bedside with one of four glucose meters by an experienced operator and by 39 nurses in a teaching hospital. For precision studies aqueous quality control materials were used. A total of 85 blood samples were tested. The precision of the glucose meters (expressed as the coefficient of variation [CV]) in the hands of the experienced operator ranged from 6.7% to 11.1%. The correlation between the values obtained by the experienced operator and the reference values obtained in the laboratory was high (0.95 to 0.98). The precision of the values obtained by the nurses using the meters ranged from 13.7% on medical wards to 45.7% in the intensive care unit (ICU). The correlation between these values and those obtained in the central laboratory ranged from 0.72 to 0.82. Twenty-four percent of the glucose values determined on medical wards and 62% of those determined in the ICU deviated from the reference value by at least 20%. Of the 85 patients 12 (14%) would have received different insulin dosages had the reference value been available at the same time as the glucose meter reading: in 3 of the patients the discrepancy was 6 units of insulin or greater. Continuous quality control of bedside monitoring of the blood glucose level is needed. In addition, personnel who use glucose meters should receive adequate training.
我们在一家教学医院中，由一名经验丰富的操作人员以及39名护士，使用四种血糖仪中的一种，评估了实验室和床边血糖水平监测的精密度和准确性。对于精密度研究，使用了水性质量控制材料。总共测试了85份血样。经验丰富的操作人员使用血糖仪的精密度（以变异系数[CV]表示）在6.7%至11.1%之间。经验丰富的操作人员所测值与实验室获得的参考值之间的相关性很高（0.95至0.98）。护士使用血糖仪所测值的精密度在普通病房为13.7%，在重症监护病房（ICU）为45.7%。这些值与中心实验室所测值之间的相关性在0.72至0.82之间。在普通病房测定的血糖值中有24%，在ICU测定的血糖值中有62%与参考值的偏差至少为20%。在这85名患者中，如果血糖仪读数时能同时获得参考值，12名患者（14%）本应接受不同剂量的胰岛素治疗：其中3名患者的差异为6单位胰岛素或更大。需要对床边血糖水平监测进行持续质量控制。此外，使用血糖仪的人员应接受充分培训。
