HbA1c水平对2型糖尿病患者红细胞及胞内血红蛋白的影响  

Effect of Hb A1c level on erythrocytes and hemoglobin in type 2 diabetics

作　　者：叶少英[1] 阮萍[2] 雍军光[3] 沈洪涛[4] 廖志红[5] 董晓蕾[1] 

机构地区：[1]广东药学院劳动卫生与环境卫生学系,广东广州510315 [2]广东药学院生物医学工程系,广东广州510310 [3]广东药学院附属门诊部内分泌科,广东广州510235 [4]广西师范大学物理科学与技术学院,广西桂林541001 [5]中山大学附属第一医院内分泌科,广东广州510080

出　　处：《中国病理生理杂志》2016年第3期549-553,共5页Chinese Journal of Pathophysiology

基　　金：广东省科技计划(No.2012B031800429;No.2014807);国家自然科学基金资助项目(No.11265005)

摘　　要：目的:探讨不同糖化血红蛋白(Hb A1c)水平对2型糖尿病(T2DM)患者红细胞及胞内血红蛋白(Hb)的影响。方法:选取健康人30名为对照组(H组),T2DM患者102例,按Hb A1c水平分为3组:血糖控制良好组(A组)30例(Hb A1c<7.0%);血糖控制较差组(B组)36例(7.0%≤Hb A1c<9.0%);持续高血糖组(C组)36例(Hb A1c≥9.0%)。利用新型静态显微图像分析技术和紫外-可见光谱技术,对各组红细胞及胞内Hb进行检测。结果:与H组比较,A、B、C组红细胞的圆度因子明显增大(P<0.05)且与Hb A1c水平呈正相关;B组红细胞的截面积和C组红细胞的全部形态参数均较H组明显增大(P<0.05);A、B、C组,除A、B组间红细胞长短轴参数无显著差异,其它组间参数比较差异有统计学显著性。与H组比较,A、B、C组Hb的紫外-可见光谱的谱型和谱峰未出现明显差异,但B、C组Hb的吸光度较H组明显下降(P<0.01),且C组Hb的吸光度也明显低于A组(P<0.05),随Hb A1c水平的升高呈逐渐下降趋势。结论:随Hb A1c水平的升高,T2DM患者红细胞的形态发生改变,变形功能逐渐减弱,胞内Hb的结构可能发生改变。AIM：To explore the effect of HbA1c level in the patients with type 2 diabetes mellitus（ T2DM）on the rheological properties of erythrocytes and the structure of hemoglobin（ Hb）.METHODS：The patients with T2 DM were classified into 3 groups：the patients with good glycaemic control（ group A,HbA1c 7.0%）,the patients with poor glycaemic control（ group B,7.0% ≤HbA1c〈 9.0%） and the patients with persistent hyperglycemia（ group C,Hb A1c≥9.0%）.The rheological properties of a single living erythrocyte were analyzed by the techniques of static imaging and analysis.Ultraviolet-visible spectroscopy was used to study the structure of Hb.RESULTS：Compared with group H,the roundness effect factor（ REF） of erythrocytes,which was positively related with HbA1c level,was significantly increased in groups A,B and C（ P〈 0.05）.The contact area of erythrocytes in group B and all the morphological parameters of erythrocytes in group C were significantly higher than those in group H（ P〈 0.05）.There were significant differences among groups A,B and C in deformation capacity and elastic parameters of the cell membrane（ P〈 0.05）,but with no difference in the long axis and short axis between group A and group B.Compared with group H,no obvious change in the spectral pattern and spectrum peak of Hb in groups A,B and C was observed.However,the absorbance of Hb,which showed a trend of gradual decline with the increase in HbA1c level,in group B and group C was significantly decreased as compared with group H（ P〈 0.01）,and the Hb absorbance in group C were also lower than that in group A（ P〈 0.05）.CONCLUSION：With the increase in HbA1c level,the morphology along with the deformation function of erythrocytes in T2 DM changes and declines gradually,and the structure of Hb may also change.

关 键 词：HBA1C 红细胞 血红蛋白 2型糖尿病 

分 类 号：R589.1[医药卫生—内分泌] R363[医药卫生—内科学]