Study On The Difference Between Fingertip Blood Glucose And Arterial Blood Glucose And Analysis Of Related Influencing Factors In Sepsis Patients

Objective:To observe the difference between fingertip blood glucose and arterial blood glucose in sepsis patients,and to analyze the factors that may cause the difference between blood glucose in fingertip and blood glucose in arteryexplore the correlation between the difference and lactate,APACHEⅡscore,and the correlation between the change value of the difference and the clearance rate of lactate,further.Methods:Select patients with sepsis who admitted to our hospital from February to December 2019,and record the results of sex,age,infection site,basic disease,temperature（abbreviated T）,mean arterial pressure（MAP）,sequential organ failure score（SOFA）,APACHEⅡscore,edema degree,use of vasoactive drugs,routine blood test at admission,etc.The arterial blood glucose,arterial lactate and fingertip capillary blood glucose were collected at admission,6 hours after admission and 24 hours after admission.SPSS 25.0 software was used to describe and analyze the data.The measurement data conforming to the normal distribution are expressed as mean±standard deviation（（?）±s）.Paired t test was used for the comparison of the mean.If the measurement data did not conform to the normal distribution,M(P₂₅,P₇₅)was used for the representation,and non-parametric test was used.Pearson correlation analysis was used for correlation analysis,while spear-man correlation analysis was used for data that did not conform to normal distribution.Result:1.78 patients with sepsis were included in this study,including 45 patients with septic shock.There were 46 males and 32 females.Age（years）60.50（46.75,68.25）;Temperature:36～38℃in 60 cases,>38℃or<36℃in18 cases.There were 52 cases with basic disease and 26 cases without basic disease.Infection sites:27 cases of respiratory tract and mediastinal infection,22 cases of abdominal cavity and intestinal tract infection,19 cases of urinary tract infection,1 case of skin and soft tissue infection,9 cases of other site infection.2. Analysis of difference between fingertip blood glucose and arterial blood glucose:The results of fingertip blood glucose（mmol/L）was 8.85（6.10,10.50）and arterial blood glucose（mmol/L）was 9.05（6.25,10.80）.There was ast atistical difference between fingertip blood glucose and arterial blood glucose（Z=-2.679,P<0.05）.3. Analysis of influencing factors of differences between blood glucose in fingertips and blood glucose in arteries:Shock,lactate>2.0mmol/L,mean arterial pressure<65mm Hg,application of vasoactive drugs,moderate to severe edema,hemoglobin<120g/L,and pH<7.35 were all factors that might affect the accuracy of blood glucose in fingertip.Sex,age,infection site,underlying disease,and body temperature were not factors that affected the accuracy of blood glucose in the fing ertips.4. Correlation analysis of the difference between arterial blood glucose and fingertip blood glucose and lactate:The difference between arterial blood glucose and fingertip blood glucose was highly positively correlated with lactate（r=0.869,P<0.05）.5. Arterial blood sugar and fingertip blood sugar difference with APACHEⅡscore correlation analysis:The difference between arterial blood glucose and fingertip blood glucose was highly positively correlated with APACHEⅡscore（r=0.741,P<0.05）.5. Correlation analysis of the change about the difference between arterial blood glucose and fingertip blood glucose（6h,24h）and the lactic acid clearance rate（6h,24h）:The difference between arterial blood glucose and fingertip blood glucose at 6h was positively correlated with the lactic acid clearance rate at 6h（r=0.642,P<0.05）,and the difference between arterial blood gluco se and fingertip blood glucose at 24h was positively correlated with the lactate clearance rate at 24h（r=0.572,P<0.05）.Conclusion:In sepsis,there is a difference between fingertip blood glucose and arterial blood glucose.Fingertip blood glucose cannot accurately reflect arterial blood glucose.Shock,lactic acid,hemoglobin,MAP,degree of edema,pH of blood,and application of vasoactive drugs may affect the accuracy of blood glucose in fingertip.The above factors should be considered in the clinical measurement of blood glucose.Arterial blood rather than fingertip blood is recommended for monitoring blood glucose.Differences between blood glucose in fingertips and blood glucose in arteries may be related to micro-circulation disorders and positively correlated with disease severity.