Fischer U
Gerhardt Katsch Institute of Diabetes, University of Greifswald, Karlsburg, Germany.
Acta Anaesthesiol Scand Suppl. 1995;104:21-9. doi: 10.1111/j.1399-6576.1995.tb04252.x.
The most advanced glucose sensors are measuring amperometrically the hydrogen peroxide generated in a stoichiometric relation to the prevailing glucose concentration during glucose oxidase-mediated glucose oxidation. They proved useful in commercially available glucose analysers and in experimental subcutaneous (sc) monitoring. Here it is shown (a) that under steady state conditions the s.c glucose concentration is nearly identical to that in blood, (b) that sc. inserted glucose electrodes do mirror the intracorporal glucose concentration both under hypo-, normo-, and hyperglycaemic conditions with a clinically relevant accuracy, (c) that automated feedback control of intracorporal glucose concentration is possible applying the output of sc. glucose sensor as an input to the computer that controls the insulin pump, and (d) that stable function of sc. sensor may be accomplished over intervals up to one day; in some cases applications over up to ten days have been reported. The underlying problem consists in an insufficient functional biostability which is a function of biocompatibility and size of the sensor, of its sterility, and of the permanent skin penetration. The latter is still required to get the device in place, to keep it in function, and to make use of the data under any condition. At this time, sc. glucose electrodes to be employed as hypoglycaemia-warning systems over one day are considered clinically important and technically achievable.
最先进的葡萄糖传感器通过安培法测量在葡萄糖氧化酶介导的葡萄糖氧化过程中与当前葡萄糖浓度呈化学计量关系产生的过氧化氢。它们已证明在市售葡萄糖分析仪和实验性皮下（sc）监测中很有用。本文表明：（a）在稳态条件下，皮下葡萄糖浓度与血液中的几乎相同；（b）皮下插入的葡萄糖电极在低血糖、正常血糖和高血糖条件下均能以临床相关的准确度反映体内葡萄糖浓度；（c）将皮下葡萄糖传感器的输出作为输入提供给控制胰岛素泵的计算机，可实现对体内葡萄糖浓度的自动反馈控制；（d）皮下传感器可在长达一天的时间间隔内实现稳定功能；在某些情况下，已报道可应用长达十天。潜在问题在于功能生物稳定性不足，这是传感器的生物相容性、尺寸、无菌性以及永久性皮肤穿透的函数。后者对于将设备放置到位、保持其功能以及在任何条件下利用数据仍然是必需的。目前，用作一天以上低血糖预警系统的皮下葡萄糖电极在临床上被认为很重要且在技术上是可行的。
