变异血红蛋白对糖化血红蛋白检测的影响与分析  

Influence and analysis of seven kinds of hemoglobin variants on HbA1c detection

作　　者：陈雨[1] 胡莹莹[1] 郝英英[1] 迟书玲[1] 赵芳[1] 张辉[1] 李薇[1] 窦亚玲[1] 

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院检验科,100730

出　　处：《中华医学杂志》2014年第6期438-441,共4页National Medical Journal of China

摘　　要：目的 探讨7种变异血红蛋白对两种糖化血红蛋白检测方法的影响.方法 收集2012年2月至2013年4月北京协和医院门诊及住院患者中变异血红蛋白（D、S、Q、G、J和F）样本25份,对照样本40份,分别用两种检测糖化血红蛋白的高效液相色谱法（HPLC）方法进行检测.比较两组数据结果与血糖的相关性,采用SPSS 19.0统计软件分析两种方法对两组样本检测的差异.结果 无变异血红蛋白对照组采用两种方法测定糖化血红蛋白有较高一致性（6.68%±1.87%比6.64%±1.99%,P＞0.05）.对于变异血红蛋白样本组,离子交换HPLC法测定糖化血红蛋白结果与亲和层析HPLC方法比较差异有统计学意义（3.57%±3.51%比4.95%±0.57%,P＜0.05）.离子交换HPLC法会受到变异血红蛋白的干扰;亲和层析HPLC方法不受这些变异血红蛋白的干扰,与血糖的相关性好.结论 常见的变异血红蛋白会干扰离子交换HPLC方法的糖化血红蛋白的检测结果,使检测结果发生偏低或偏高;亲和层析HPLC方法不受变异血红蛋白的干扰,检测特异性强.Objective To explore the effects of seven kinds of hemoglobin variants on two HbAlc detection methods. Methods Twenty-five hemoglobin variant samples （Hb D,S,Q,G,J,E ＆ F） and 40 control samples were from February 2012 to April 2013 collected. All samples were tested by ion exchangehigh performance liquid chromatography system （IE-HPLC） and affinity ehromatogragh-high performance liquid chromatography （AC-HPLC） respectively. We compared the coincidence between HbAlc results of two instruments and blood glucose and observed the difference between variant and control groups for two methods using statistic software SPSS 19.0. Results A high consistency existed between [E-HPLC and AC- HPLC in the control group with no hemoglobin variants（6. 68% ± 1.87% vs 6. 64% ± 1.99% ,P 〉0. 05）. For the hemoglobin variants group, the results of HbA1 c via IE-HPLC were interfered by hemoglobin variants （3.57% ±3.51% 比 4. 95% ±0.57%,P 〈0.05）.However, HbAlc detection of AC-HPLC had no interference with hemoglobin variants and it demonstrated an excellent correlation with blood glucose. Conclusions The results of HbAlc in blood samples containing common hemoglobin variants may be interfered on IE-HPLC to be falsely lower or higher. Only detecting glycated hemoglobin with strong specificity,AC-HPLC is well-correlated with blood glucose and its results are not interfered by common variant hemoglobin.

关 键 词：糖尿病 糖化血红蛋白 

分 类 号：R446.1[医药卫生—诊断学]