尼泊尔两种用于检测新生儿低血糖的床边方法的比较。

Comparison of two cotside methods for the detection of hypoglycaemia among neonates in Nepal.

作者信息

Ellis M, Manandhar D S, Manandhar N, Land J M, Patel N, de L Costello A M

机构信息

Institute of Child Health, University of London.

出版信息

Arch Dis Child Fetal Neonatal Ed. 1996 Sep;75(2):F122-5. doi: 10.1136/fn.75.2.f122.

DOI:10.1136/fn.75.2.f122

PMID:8949696

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1061176/

Abstract

AIMS

To compare two cotside methods of blood glucose measurement (HemoCue and Reflolux II) against a standard laboratory method for the detection of neonatal hypoglycaemia in a developing country maternity hospital where hypoglycaemia is common.

METHODS

94 newborn infants and 75 of their mothers had blood glucose assessed on the same venous sample using three different methods in the Special Care Baby Unit and postnatal wards, Prasuti Griha Maternity Hospital, Kathmandu, Nepal: HemoCue and Reflolux II at the cotside; Roche Ultimate glucose oxidase method (GOM) in the laboratory.

RESULTS

The mean (SD) values for blood glucose in newborn infants were GOM 2.5 (1.1) mmol/l; Reflolux II 2.1 (0.9); and HemoCue 4.2 (1.2). For mothers the values were GOM 5.3 (1.2) mmol/l; Reflolux II 3.6 (1.2); and HemoCue 5.6 (1.0). Bland-Altman plots showed that Reflolux II consistently underreads GOM blood glucose in neonates by 0.5 mmol/l (SD 0.7) and that HemoCue overreads glucose by 1.7 mmol/l (SD 0.8). For the detection of hypoglycaemia (< 2.0 mmol/l), Reflolux II achieved a sensitivity of 83%, a specificity of 62%, and a likelihood ratio of 2.2. HemoCue produced a sensitivity of 0% and a specificity of 100% using measured values. If 2.0 mmol were subtracted from all Hemocue values this rose to 81% and 68% and a likelihood ratio of 2.5.

CONCLUSION

Although more accurate than Reflolux II for the measurement of blood glucose in mothers, HemoCue overreads glucose concentrations in neonates and is therefore potentially dangerous as a screening method for neonatal hypoglycaemia. Reflolux II is useful as a screening method for high risk infants (low birthweight, post-term) and could achieve a post-test probability of detecting hypoglycaemia in a high risk setting like Nepal of 50-60%.

摘要

目的

在低血糖常见的发展中国家妇产医院，比较两种床边血糖测量方法（HemoCue和Reflolux II）与标准实验室方法在检测新生儿低血糖方面的效果。

方法

在尼泊尔加德满都Prasuti Griha妇产医院的特别护理婴儿室和产后病房，对94名新生儿及其75名母亲的同一静脉血样本，使用三种不同方法评估血糖：床边使用HemoCue和Reflolux II；实验室使用罗氏终极葡萄糖氧化酶法（GOM）。

结果

新生儿血糖的均值（标准差）分别为：GOM 2.5（1.1）mmol/L；Reflolux II 2.1（0.9）；HemoCue 4.2（1.2）。母亲们的血糖值分别为：GOM 5.3（1.2）mmol/L；Reflolux II 3.6（- 1.2）；HemoCue 5.6（1.0）。Bland - Altman图显示，Reflolux II在新生儿中始终比GOM血糖读数低0.5 mmol/L（标准差0.7），而HemoCue比葡萄糖读数高1.7 mmol/L（标准差0.8）。对于低血糖（<2.0 mmol/L）的检测，Reflolux II的灵敏度为83%，特异性为62%，似然比为2.2。使用测量值时，HemoCue的灵敏度为0%，特异性为100%。如果从所有HemoCue值中减去2.0 mmol，灵敏度升至81%，特异性升至68%，似然比为2.5。