Deng Ting, Liu Mengjiao, Pan Lu, Jiang Kai, Li Yi
Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, China.
Ann Palliat Med. 2021 Mar;10(3):3179-3184. doi: 10.21037/apm-21-354.
This study explored the differences, correlation, and consistency between blood glucose levels measured using an arterial blood gas analyzer and a rapid blood glucose meter in critically ill patients.
A total of 73 critically ill patients admitted to the Department of Critical Care Medicine, from October to December 2016 were enrolled in this study. The patient's arterial blood glucose was measured by arterial blood gas analyzer, while peripheral blood glucose was measured by a rapid blood glucose meter (via the non-infusion limb). The correlation between indicators was analyzed using the linear regression model. Bland-Altman was performed to evaluate the agreement of the two methods for measuring blood glucose. P<0.05 was considered statistically significant.
The blood glucose values measured using the arterial blood gas analyzer was significantly different from the values obtained using the rapid blood glucose meter (P=0.000). Regression analysis showed that R2 was 0.857 and β was 0.324 (P=0.000). Bland-Altman plot analysis showed that arterial blood glucose values obtained using the arterial blood gas analyzer were higher than the peripheral blood glucose values obtained using the rapid blood glucose meter on the non-infused limb, with 2.74% of dots lying outside the 95% limit of agreement and the maximum absolute value (2.30 mmol/L) of blood glucose difference within the limit of agreement. The blood glucose levels measured using the two different methods showed good agreement.
The difference in blood glucose values measured using the two different measurement methods was statistically significant, but the maximum absolute value (2.30 mmol/L) of blood glucose difference within the limit of agreement, which is acceptable in the clinical setting. In clinical care, it is not necessary to repeat a measure of the patient's capillary blood glucose (CBG) using the rapid blood glucose meter after the blood glucose levels have been measured with the arterial blood gas analyzer, thereby reducing the associated pain and inconvenience for the patients.
本研究探讨了危重症患者使用动脉血气分析仪和快速血糖仪测量血糖水平之间的差异、相关性和一致性。
选取2016年10月至12月入住重症医学科的73例危重症患者纳入本研究。采用动脉血气分析仪测量患者动脉血糖，同时采用快速血糖仪（经非输液肢体）测量外周血糖。使用线性回归模型分析指标之间的相关性。采用Bland-Altman法评估两种血糖测量方法的一致性。P<0.05认为差异有统计学意义。
动脉血气分析仪测量的血糖值与快速血糖仪测量的值有显著差异（P=0.000）。回归分析显示，R2为0.857，β为0.324（P=0.000）。Bland-Altman图分析显示，动脉血气分析仪测得的动脉血糖值高于非输液肢体上快速血糖仪测得的外周血糖值，95%一致性界限外的点占2.74%，血糖差值的最大绝对值（2.30 mmol/L）在一致性界限内。两种不同方法测量的血糖水平显示出良好的一致性。
两种不同测量方法测得的血糖值差异有统计学意义，但血糖差值的最大绝对值（2.30 mmol/L）在一致性界限内，在临床环境中是可接受的。在临床护理中，使用动脉血气分析仪测量血糖水平后，无需再用快速血糖仪重复测量患者的毛细血管血糖（CBG）水平，从而减轻患者的相关疼痛和不便。
