持续糖监测系统在兔低血糖模型中的应用评估

发布时间：2018-06-15 11:15

本文选题：持续糖监测系统 + 低血糖　；参考：《中国比较医学杂志》2017年03期

【摘要】：目的建立兔低血糖模型,并评估皮下持续糖监测系统(CGMS)在低血糖监测时的准确性和及时性。方法选用雌性新西兰大耳白兔16只,随机分为4组,每组4只。对照组为持续静脉注射生理盐水,实验组动物持续静脉注射胰岛素,根据剂量不同分为胰岛素0.1 U/(kg·h)组(RI=0.1 U组)、胰岛素0.2 U/(kg·h)组(RI=0.2 U组)和胰岛素0.4 U/(kg·h)组(RI=0.4 U组)。试验期间实施监测CGMS 240 min,间隔30 min采集耳缘静脉血,由手持血糖测定仪监测血糖(BG监测值)。结果研究期间共获得CGMS监测数据1296个,与CGMS时间匹配的BG监测数据136个。应用胰岛素后BG和CGMS均明显降低,RI=0.1U组BG和CGMS降低速度分别为每分钟0.016和0.017 mmol/L;RI=0.2U组分别为每分钟0.04和0.027 mmol/L;RI=0.4 U组分别为每分钟0.049和0.032 mmol/L。按照BG监测值是否低于4.4 mmol/L将BG-CGMS配对数据分为低血糖和正常血糖两类。低血糖时BG-CGMS的平均偏差为0.55 mmol/L(上下限:-0.98~2.08 mmol/L),绝对差值百分率(RAD)为40.2%±45.2%;正常血糖时的BG-CGMS平均偏差为-0.19 mmol/L(上下限:-1.38~1.00 mmol/L),RAD为5.8%±5.3%。误差栅格分析(EGA)显示A区占比为93.4%,B区为0.7%,D区为5.9%,且D区均分布于BG低CGMS高的区域。结论本研究结果提示,当血糖降低速度增快时,CGMS出现明显的滞后现象,当血糖降低至4.4mmol/L以下时,CGMS存在高估血糖的危险。CGMS临床应用时应充分考虑这种危险。
[Abstract]:Objective to establish a rabbit model of hypoglycemia and to evaluate the accuracy and timeliness of hypoglycemia monitoring system (CGMS). Methods Sixteen female New Zealand white rabbits were randomly divided into 4 groups. The control group was continuously injected with normal saline, and the experimental group was continuously injected with insulin by intravenous injection. The rats in the experimental group were divided into three groups: insulin 0.1 U / kg / h) group, insulin 0.2 U / kg / kg group) and insulin 0.4 U / kg / kg group. During the experiment, the CGMs were monitored for 240 minutes, and the venous blood samples were collected at intervals of 30 min. The blood glucose levels were monitored by a hand-held blood glucose analyzer. Results 1296 CGMs monitoring data and 136 BG monitoring data matched with CGMS time were obtained during the study. The reduction rates of BG and CGMs were 0.016 and 0.017 mmol 路L ~ (-1) 路min ~ (-1) 路min ~ (-1) in BG and CGMS 0.2U group, respectively, 0.04 and 0.027 mmol 路L ~ (-1) 路min ~ (-1) 路min ~ (-1) in RII-0.4U group, 0.049 and 0.032 mmol 路L ~ (-1) 路min ~ (-1) respectively. BG-CGMS paired data were classified into hypoglycemia and normal blood glucose according to whether the BG monitoring value was less than 4.4 mmol / L. The average deviation of BG-CGMS at hypoglycemia was 0.55 mmol / L (upper and lower limit: -0.98 卤2.08 mmol / L, absolute difference percentage = 40.2% 卤45.2%), and the average deviation of BG-CGMS at normal blood glucose was -0.19 mmol / L (upper and lower limit: -1.381.00 mmol / L = 5.8% 卤5.3%). Error grid analysis (EGA) showed that the proportion of area A was 93.4B and the ratio of area B was 0.70.The area D was 5.9. and the region D was distributed in the regions with low BG and high CGMS. Conclusion the results of this study suggest that there is a significant lag phenomenon in CGMS when the blood glucose decreases more rapidly, and the risk of overestimation of blood glucose in CGMS should be taken into account when the blood glucose drops below 4.4 mmol / L. The risk of CGMS should be taken into account when it is used in clinical practice.
【作者单位】：民航总医院重症医学科;
【分类号】：R587.3;R-332

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