天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (8): 936-938.doi: 10.11958/j.issn.0253-9896.2015.08.029

• 诊断技术 • 上一篇    下一篇

探讨实时动态血糖监测在2 型糖尿病患者中的准确性

张春风1，葛焕琦1△，谢云2，郑辉1   

  1. 1泰达国际心血管病医院内分泌科（邮编300457）；2天津医科大学代谢病医院神经内科
  • 收稿日期:2014-12-17 修回日期:2015-03-26 出版日期:2015-08-15 发布日期:2015-08-15
  • 通讯作者: 葛焕琦 E-mail:gehuanqi@163.com
  • 作者简介:张春风（1989），女，主治医师，硕士，主要从事糖尿病及相关并发症发病机制研究

Investigate the accuracy of real-time continuous glucose monitoring system in the type 2 diabetes subjects

ZHANG Chunfeng1, GE Huanqi1△, XIE Yun2, ZHENG Hui1   

  1. 1 Department of Endocrinology, TEDA International Cardiovascular Disease Hospital, Tianjin 300457, China 2 Department of Neurology, Metabolic Disease Hospital of Tianjin Medical University
  • Received:2014-12-17 Revised:2015-03-26 Published:2015-08-15 Online:2015-08-15

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摘要： 目的探讨实时动态血糖监测（RT-CGM）在2 型糖尿病（T2DM）患者中的准确性。方法选取2013 年5 月—2014 年8 月于我院住院治疗的T2DM 患者318 例作为研究对象。所有受试者佩戴RT-CGM 检测仪，每日输入至少4 个指端血糖进行校正。依指端血糖水平将受试者分为3 组：≤6.99 mmol/L 组、7.0~10.0 mmol/L 组和≥10.01 mmol/L 组，分析指端血糖与探头血糖的相关性，并应用Clarke 错误栅格分析评价RT-CGM 的准确性。结果（1）本研究共得到2 815 对指端血糖-探头血糖数据，探头血糖与指端血糖呈正相关（r=0.847），对指端血糖水平分组后分析显示：两者的相关性随血糖值的升高而升高（r 分别为0.457、0.648 和0.852，P＜0.001）。（2）Clarke 错误栅格分析显示：RT-CGM 值的临床准确率为76.69%（A 区），可接受率为20.28%（B 区），临床不可接受血糖比例为3.03%（C~E 区）。指端血糖≤6.99 mmol/L 时的临床准确率低于7.0~10.0 和≥10.01 mmol/L 时（73.12% vs 78.63% & 79.28%，P＜ 0.05），而后2 组水平的临床准确率差异无统计学意义。结论RT-CGM 具有良好的准确性，尤其是在高血糖时其准确性更稳定。

关键词: 糖尿病, 2 型, 实时动态血糖监测, 准确性, 错误栅格分析

Abstract: Objective To investigate the accuracy of real-time continuous glucose monitoring（RT-CGM）system in the type 2 diabetes mellitus（T2DM）. Methods A total of 318 subjects hospitalized between 2013 May to 2014 August were recruited. Each subject received a RT-CGM system. In order to calibrate the interstitial glucose level, finger-stick blood glucose were measured at least four times every day. Patients were divided into three groups according to their fingerstick blood glucose level: ≤6.99 mmol/L, 7.0-10.0 mmol/L and ≥10.01 mmol/L. Pearson correlation was used to analyze the relationship between the finger-stick glucose and interstitial glucose gained from RT-CGM. Clarke error grid analysis was used to analyze the accuracy of RT-CGM. Results （1）A total of 2, 815 glucose meter values from finger-stick were com⁃ paired with glucose from RT-CGM. A positive relationship（r=0.847）were found between CGM and finger-stick blood glu⁃ cose. The correlation was closer with higher finger-stick blood glucose levels（r=0.457, 0.648 and 0.852 respectively in ≤ 6.99 mmol/L group, 7.0-10.0 mmol/L group and ≥10.01 mmol/L group. P＜0.001）.（2）The Clarke error grid analysis re⁃ vealed that 76.69% of the readings from RT-CGM were clinical perfect (zone A), 20.28% were acceptable (zone B), 3.03% were unacceptable (zone C-E). Clinical perfect rate was lower when the finger-stick glucose ≤6.99 mmol/L , compared with that when it is between 7.0-10.0 or ≥10.01 mmol/L group（73.12% vs 78.63% & 79.28%，P＜0.05）, there was no significant difference between group of 7.0-10.0 mmol/L with group ≥10.01 mmol/L (P＞0.05). Conclusion RT-CGM provides accu⁃ rate blood glucose values to guide the treatment of diabetes, and the accuracy is more reliable in high glucose environment.

Key words: diabetes mellitus, type 2, real-time continuous glucose monitoring, accuracy, error grid analysis