한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제13권4호
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  • Pages.1751-1758
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  • 2012
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  • 1975-4701(pISSN)
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  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
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팔, 손가락, 정맥에서 채취한 혈액의 혈당검사결과 비교 분석

Comparative analysis of blood glucose test results on the forearm, finger, and vein

  • 김경아 (충북대학교 의과대학 의공학교실) ;
  • 이인광 (충북대학교 의과대학 의공학교실) ;
  • 신은영 (충북대학교 의과대학 생화학교실) ;
  • 김양미 (충북대학교 의과대학 생리학교실) ;
  • 김경옥 (서울아산병원 간호부) ;
  • 차은종 (충북대학교 의과대학 의공학교실) ;
  • 박경순 (충청대학교 간호학과)
  • Kim, Kyung-Ah (Dept. of Biomedical Engineering, College of Medicine, Chungbuk National University) ;
  • Lee, In-Kwang (Dept. of Biomedical Engineering, College of Medicine, Chungbuk National University) ;
  • Shin, Eun-Young (Dept. of Biochemistry, College of Medicine, Chungbuk National University) ;
  • Kim, Yang-Mi (Dept. of Physiology, College of Medicine, Chungbuk National University) ;
  • Kim, Kyoung-Oak (Seoul Asan Medical Center) ;
  • Cha, Eun-Jong (Dept. of Biomedical Engineering, College of Medicine, Chungbuk National University) ;
  • Park, Kyung-Soon (Dept. of Nursing, Chungcheong University)
  • 투고 : 2012.01.17
  • 심사 : 2012.04.12
  • 발행 : 2012.04.30
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초록

팔부위에서 혈당을 측정하는 것은 모세혈관에서 혈액을 채취하는 동안 느끼는 통증을 줄일 수 있다. 본 연구에서는 팔부위 혈당검사의 임상적 유효성을 평가하기 위해 팔부위 혈당검사결과를 손가락 및 정맥에서의 혈당검사결과와 각각 비교하였다. 당뇨환자 61명이 포함된 555명의 피검자를 대상으로 금식 상태에서 휴대형 혈당계로 손가락과 팔 안쪽 부위에서 혈당검사를 수행하였으며, 1시간 이내에 피검자 514명의 정맥혈액으로 혈당검사를 수행하였다. 측정값들에 대해 선형회귀분석, 급내 상관분석(intraclass correlation), Passing-Bablok 회귀분석 기법으로 다양하게 비교 분석해 보았다. 팔부위 혈당값은 환자군에서 손가락 및 정맥 혈당값과의 상관계수(r)가 0.97(P<0.0001)로 높은 선형관계를 나타내었으며, 정상군에서도 r값이 약간 작았지만 유사하였다. 채혈 부위에 따른 혈당값의 평균 차이는 두 집단에서 모두 ${\pm}10mg/dL$ 이내이었다. 급내 상관계수는 r값에 비교하여 약간 작았지만 두 집단이 유사한 수치를 나타내었다. Passing-Bablok 분석에서 기울기의 95% 신뢰구간과 절편은 각각 < ${\pm}20%$, < ${\pm}20mg/dL$로서 임상 허용범위 이내의 값을 나타내었다. 본 연구에서 사용한 세 가지 통계분석 결과 팔부위 혈당값이 손가락과 정맥에서 측정한 혈당값과 충분히 일치함이 입증되었다. 팔부위 혈당검사가 표준방법인 손가락 혈당검사와 높은 일치성을 나타내었으므로 금식 상태에서의 임상적용 가능성을 확인할 수 있었다.

Capillary blood sampling on the forearm reduces pain caused by skin puncture. The present study compared the blood glucose test results performed at different sampling sites of the forearm, finger, and vein to evaluate clinical validity of this alternative site blood sampling technique. Subjects numbered 555 including 61 diabetic patients participated to measure the glucose concentration on the finger ($G_F$) and the forearm ($G_A$) with a portable glucometer under overnight fasting state. Then, the venous glucose concentration ($G_V$) was measured in 514 subjects in less than 1 hour. The test results were analyzed by simple linear regression, intraclass correlation, and Passing-Bablok regression techniques. $G_A$ was highly correlated with $G_F$ or $G_V$ showing the correlation coefficients (r) of approximately 0.97 (P<0.0001) in the normal group. The patient group also resulted similarly high correlation with only slightly lower r value. The mean differences in glucose concentration were less than ${\pm}10mg/dL$ regardless of the sampling sites. Intraclass correlation coefficients were slightly smaller than r but very much similar in value in both groups. The 95% confidence intervals of the slope as well as the intercept in the Passing-Bablok regression analysis were < ${\pm}20%$ and < ${\pm}20mg/dL$, respectively, which were within the clinically acceptable ranges. These three statistical techniques introduced in the present study well demonstrated the consistency of $G_A$ with $G_F$ and $G_V$. Therefore, the forearm blood glucose test could be considered as clinically valid under fasting condition.

키워드

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