快速血酮检测仪检测血β-羟丁酸水平对住院糖尿病患者酮症的筛查价值

摘要

目的 应用快速血酮检测仪对住院糖尿病患者常规检测毛细血管全血β-羟丁酸水平,探讨其诊断的准确性以及诊断糖尿病酮症(DK)的价值.方法 对住院治疗的228例糖尿病患者,应用快速血酮检测仪测定毛细血管全血β-羟丁酸水平,并同步检测指尖血糖、静脉血糖、尿酮体、动脉血pH值及HCO-3水平,分析血酮与尿酮体、指尖血糖、静脉血糖、血PH值以及HCO-3的相关性,评估这种检测方法的准确性,利用血β-HBA及尿酮体对DK诊断的价值及差异性.结果 血β-羟丁酸水平与尿酮体的相关系数为0.617(P<0.01),与指尖血糖的相关系数为0.203(P<0.01),与静脉血糖的相关系数为0.423(P<0.01),与动脉血pH值得相关系数为-0.487(P<0.01),与HCO-3的相关系数为-0.683(P<0.01).利用血β-羟丁酸检测结果,诊断DK54例,利用尿酮体检测结果,诊断DK67例,两种方法诊断一致者38例.结论 快速血酮检测仪可快速、准确地测定毛细血管全血β-羟丁酸水平,与尿酮体、指尖血糖、静脉血糖呈正相关,与血PH、HCO-3呈负相关,与利用尿酮体诊断DK的传统方法相比,具有良好的可比性,可及时、有效、便捷地筛查DK.%Objective To explore the diagnosis accuracy and value for diabetic ketosis(DK)of quick blood ketone meter on screening the capillary blood β-hydroxybutyric(β-HBA)acid in inpatients with diabetes.Methods The capillary blood β-HBA of 228 cases of inpatients with diabetes were detected by quick blood ketone mater.Meantime the fingertip blood glucose,venous plasma glucose,urine ketone bodies and the level of pH and the concentration of HCO-3 in arterial blood were detected,and the correlation between those indicators above and blood ketone were analyzed.Then we assessed the accuracy of quick blood ketone meter in diagnosing DK,and compared the value and difference in diagnosing DK by testing blood β-HBA and urine ketone bodies.Results The correlation coefficient of blood β-HBA and urine ketone bodies was 0.617(P<0.01),0.203(P<0.01)between blood β-HBA and fingertip blood glucose,0.423(P<0.01)between blood β-HBA and venous plasma glucose,-0.487(P<0.01)between blood β-HBA and arterial blood pH,and-0.683(P<0.01)between bloodβ-HBA and the concentration of HCO-3 in arterial blood.54 cases diagnosed with DK by bloodβ-HBA while 67 cases by urine ketone bodies.Two methods of diagnosis were consistent in 38 cases.Conclusion Quick blood ketone meter could detect blood β-HBA level rapidly and accurately.The blood β-HBA was correlate positively with urine ketone bodies,fingertip blood glucose and venous plasma glucose,and negatively with arterial blood pH and HCO-3 concentration.Compared with conventional methods,quick blood ketone meter could screen DK timely,effectively and conveniently.