INTRODUCTION The ratio of cerebrospinal fluid (CSF) glucose and blood glucose is of major relevance, conducting to the diagnosis of hypoglycorrhachia, which is a sign of neuroinfection, as well as a number of neurological diseases of genetic or neoplastic etiology. Glucose in capillary sample (glucometry) is a low cost, readily available technique, as compared to venous glucose. This study aims to compare glucometry to venous glucose in the diagnosis of hypoglycorrhachia in pediatric population. METHODS Prospective cross-sectional study based on data obtained from lumbar punctures in the period from February 2017 to January 2019 in a specialized pediatric institution in Colombia. RESULTS 97 patients were analyzed, aged 1 month to 17 years old, mean 7.67 years, 52 (53.61%) were female. 26 (26.8%) were diagnosed with hypoglycorrhachia. Pearson correlation coefficient for absolute venous and capillary glucose was 0.54, and 0.55 for the ratios of CSF glucose/venous glucose and CSF glucose/glucometry, which support a linear correlation between the variables in both, absolute values and ratios. Intraclass correlation coefficient was calculated for both, the venous glucose and glucometry ratios, which was 0.52, revealing a moderate agreement among the tests. Sensitivity and specificity of CSF glucose/glucometry, as compared to gold standard are 73.1% and 60.6% respectively; whereas predictive positive value (PPV) and negative predictive value (NPV), were 40.4% and 86.0%. CONCLUSION Glucometry cannot replace the glucose in venous sample in the diagnosis of hypoglycorrhachia in children.

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毛细血管诊断率与静脉葡萄糖在儿童低血糖诊断中的比较：一项前瞻性、观察性研究

引言 脑脊液 (CSF) 葡萄糖和血糖的比率具有重要的相关性，可用于诊断低血糖症，这是神经感染的征兆，以及许多遗传或肿瘤病因的神经系统疾病。与静脉葡萄糖相比，毛细血管样品中的葡萄糖（血糖测定法）是一种低成本、容易获得的技术。本研究旨在比较血糖测定法与静脉葡萄糖在儿科人群中低血糖症的诊断中的作用。方法 前瞻性横断面研究，基于 2017 年 2 月至 2019 年 1 月期间在哥伦比亚一家专业儿科机构腰椎穿刺获得的数据。结果共分析97例患者，年龄1个月～17岁，平均7.67岁，女性52例（53.61%）。26 人 (26.8%) 被诊断为低血糖症。绝对静脉和毛细血管葡萄糖的 Pearson 相关系数为 0.54，脑脊液葡萄糖/静脉葡萄糖和脑脊液葡萄糖/血糖的比率为 0.55，这支持绝对值和比率变量之间的线性相关性。计算静脉葡萄糖和血糖测定比率的组内相关系数，为 0.52，表明测试之间具有中等一致性。与金标准相比，CSF 葡萄糖/血糖测定法的灵敏度和特异性分别为 73.1% 和 60.6%；而预测阳性值 (PPV) 和阴性预测值 (NPV) 分别为 40.4% 和 86.0%。结论 血糖测定不能替代静脉血葡萄糖在儿童低血糖症的诊断中。55 用于 CSF 葡萄糖/静脉葡萄糖和 CSF 葡萄糖/血糖测定法的比率，这支持绝对值和比率变量之间的线性相关性。计算静脉葡萄糖和血糖测定比率的组内相关系数，为 0.52，表明测试之间具有中等一致性。与金标准相比，CSF 葡萄糖/血糖测定法的灵敏度和特异性分别为 73.1% 和 60.6%；而预测阳性值 (PPV) 和阴性预测值 (NPV) 分别为 40.4% 和 86.0%。结论 血糖测定不能替代静脉血葡萄糖在儿童低血糖症的诊断中。脑脊液葡萄糖/静脉葡萄糖和脑脊液葡萄糖/血糖测定的比率为 55，支持绝对值和比率变量之间的线性相关性。计算静脉葡萄糖和血糖测定比率的组内相关系数，为 0.52，表明测试之间具有中等一致性。与金标准相比，CSF 葡萄糖/血糖测定法的灵敏度和特异性分别为 73.1% 和 60.6%；而预测阳性值 (PPV) 和阴性预测值 (NPV) 分别为 40.4% 和 86.0%。结论 血糖测定不能替代静脉血葡萄糖在儿童低血糖症的诊断中。计算静脉葡萄糖和血糖测定比率的组内相关系数，为 0.52，表明测试之间具有中等一致性。与金标准相比，CSF 葡萄糖/血糖测定法的灵敏度和特异性分别为 73.1% 和 60.6%；而预测阳性值 (PPV) 和阴性预测值 (NPV) 分别为 40.4% 和 86.0%。结论 血糖测定不能替代静脉血葡萄糖在儿童低血糖症的诊断中。计算静脉葡萄糖和血糖测定比率的组内相关系数，为 0.52，表明测试之间具有中等一致性。与金标准相比，CSF 葡萄糖/血糖测定法的灵敏度和特异性分别为 73.1% 和 60.6%；而预测阳性值 (PPV) 和阴性预测值 (NPV) 分别为 40.4% 和 86.0%。结论 血糖测定不能替代静脉血葡萄糖在儿童低血糖症的诊断中。