变异血红蛋白对2种基于HPLC原理的糖化血红蛋白检测系统的影响  

Effect of hemoglobin variants on the derermination of glycohemoglobin by two high performance liquid chromatography-based methods

作　　者：缪怡[1] 徐雪亮 金洁美[1] 李水军[1] 沈博[1] 

机构地区：[1]上海市徐汇区中心医院中心实验室,上海200031 [2]上海市长宁区光华医院检验科,上海200052

出　　处：《检验医学》2009年第4期251-254,共4页Laboratory Medicine

摘　　要：目的比较亲和层析-高效液相色谱（AC—HPLC）系统和离子交换-高效液相色谱（IE—HPLC）系统测定血红蛋白（Hb）结构不同的血液样本中HbAlc的结果，评价变异Hb对2种检测系统的影响。方法分别用2种HPLC系统同时检测HbAlC含量在5％-11％、Hb结构正常的血液样本和含有不同浓度胎儿Hb（HbF）的血液样本以及α-地中海贫血（α-MA）和β-地中海贫血（β—MA）患者血液样本中的HbAlC浓度。结果对于Hb结构正常、HbAlC含量在5％～11％的血液样本，2种HPLC检测系统的测定结果差异无统计学意义（P〉0．05）。AC—HPLC法不受血液样本中HbF的干扰；若血液样本中HbF的含量超过8．8％，IE—HPLC法测定结果存在-定的偏倚，当HbF含量达70％时甚至无法测出结果。对于α-MA和轻型β-MA患者的血液样本，IE—HPLC法的结果明显高于AC—HPLC法（P〈0．01、P〈0．05），而重型β—MA患者的样本用IE-HPLC法甚至无法测得结果。结论用IE—HPLC法检测含变异Hb、HbF的样本中的HbAlc，结果可能受干扰；而用AC—HPLC法则不受干扰。Objective To compare the results of HbAlc in blood samples with various configuration of hemoglobin （Hb） by affinity chromatogragh-high performance liquid chromatography（AC-HPLC）system and ion exchange-high performance liquid chromatography （ IE-HPLC ） system, and evaluate the effect of glycohemoglobin variants on AC-HPLC and IE-HPLC. Methods The levels of HbAlc in 30 blood samples with the normal Hb configuration and the HbAlc levels were 5%-11% , the blood samples with different HbF levels and the blood samples of patients with a-Mediterranean ane- mia （α-MA）and β-Mediterranean anemia （β-MA） were deteimined by AC-HPLC and IE-HPLC ,respectively. Results There was not difference between the AC-HPLC and IE-HPLC for the blood sanples with normal Hb configuration and the HbAlc levels were 5%-11% （P 〉 0.05）. There was not interference with HbF for HbAlc determation by AC- HPLC. However,the bias of HbAlc determination by IE-HPLC was occurred when HbF level 〉 8.8% ,and the HbAlc was undetectable when HbF level was 70%. For blood samples with patients with α-MA and mitis α-MA, the results of HbAlc deteremind by IE-HPLC were significantly higher than AC-HPLC （P 〈 0. 01 and P 〈 0.05, respectively）. The level of HbAlc in patient with gravis type β-MA was undetected by IE-HPLC. Conclusions The results of HbAlc in blood samples containing Hb variants or HbF may be interfered when analyzed by IE-HPL. However, there was not inter- ferences with AC-HPLC.

关 键 词：糖化血红蛋白 变异血红蛋白 离子交换-高效液相色谱 亲和层析-高效液相色谱 

分 类 号：R446.1[医药卫生—诊断学]