变异血红蛋白和氨基甲酰血红蛋白对糖化血红蛋白测定干扰的评价  

The evaluation of the interference of variant hemoglobin and carbamino hemoglobin to the detection of glycosylated hemoglobin

作　　者：康建华[1] 杨立顺[1] 袁海生[1] 

机构地区：[1]天津市中医药大学附属北辰中医医院检验科,天津300400

出　　处：《检验医学》2012年第6期482-485,共4页Laboratory Medicine

摘　　要：目的评价变异血红蛋白和血红蛋白衍生物氨基甲酰血红蛋白对离子交换-高效液相色谱(HPLC)系统和用酶法检测糖化血红蛋白(HbAlc)的影响。方法分别用2种方法同时检测无尿毒症糖尿病患者血红蛋白结构正常的血液样本和含有不同浓度胎儿血红蛋白(HbF)的血液样本及尿毒症患者HbA1c浓度。结果对于血红蛋白结构正常且无尿毒症的糖尿病患者,2种方法的HbA1c检测结果差异无统计学意义(P>0.05)。当HbF<8.75%时,离子交换-HPLC的HbA1c测定结果与预期值无差异;当样本中HbF浓度为8.8%～23.0%时,其HbA1c测定结果要明显低于理论浓度;当HbF浓度达35.0%～70.0%时,离子交换-HPLC无法检测出结果。因尿毒症患者血液中含氨基甲酰血红蛋白,所以离子交换-HPLC的HbA1c检测结果明显高于酶法;而酶法检测HbA1c不受血液中HbF和氨基甲酰血红蛋白的干扰。结论采用离子交换-HPLC检测含HbF和氨基甲酰血红蛋白的样本中的HbA1c时,结果可能受到干扰;而酶法检测HbA1c时几乎不受样本中HbF和氨基甲酰血红蛋白的干扰。Objective To evaluate the influence of variant hemoglobin and hemoglobin derivative carbamino hemoglobin on the detection of glycosylated hemoglobin （HbAlc） by ion exchange-high performance liquid chromatography （HPLC） and enzymatic method. Methods The normal hemoglobin structure diabetes mellitus patients＇ samples without uremia, the fetal hemoglobin （HbF） samples and the concentration of HbA1 c in patients with uremia were detected by the 2 methods simultaneously. Results There was no significant difference between the 2 methods for the HbAI c concentration in the normal hemoglobin structure diabetes mellitus samples without uremia （ P 〉 0.05 ）. For the ion exchange-HPLC, when HbF 〈 8.75% , there was no significant difference between the measured results and the expected value. When HbF was 8.8% -23.0%, the results were significantly lower than the theoretical concentration of HbAlc. When HbF was 35. 0%-70. 0% , the concentration of HbAlc can not be detected. For the carbamino hemoglobin, the HbAlc concentration in patients with uremia by ion exchange-HPLC was significantly higher than that by enzymatic method. Enzymatic method of HbAlc could not be interfered by HbF and carbamino hemoglobin. Conclusions The determination of HbAlc is influenced by HbF and carbamino hemoglobin by ion exchange-HPLC. There is no interference by enzymatic method.

关 键 词：氨基甲酰血红蛋白 变异血红蛋白 离子交换-高效液相色谱 酶法 糖化血红蛋白 

分 类 号：R446.1[医药卫生—诊断学]