地贫患者血红蛋白A与高效液相色谱法检测HbA1c的相关性研究  

Study on correlation between hemoglobin A and HbA1c detected by high performance liquid chromatography in thalassaemia patients

作　　者：赵素素 黄芳 秦雪[1] ZHAO Susu;HUANG Fang;QIN Xue(Department of Clinical Laboratory,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Clinical Laboratory,Guilin People's Hospital,Guilin 541002,China)

机构地区：[1]广西医科大学第一附属医院检验科,530021 [2]桂林市人民医院检验科,541002

出　　处：《中国实用医药》2025年第4期70-73,共4页China Practical Medicine

摘　　要：目的研究地中海贫血(地贫)患者血红蛋白A(HbA)水平对高效液相色谱法(HPLC)检测糖化血红蛋白(HbA1c)结果的影响。方法124例地贫患者,按地贫基因型分为α地贫患者42例、β地贫患者74例、α合并β地贫患者8例,按HbA含量不同将β地贫患者分成HbA<20%患者22例、HbA20%~40%患者5例、HbA41%~60%患者9例、HbA61%~80%患者8例和HbA>80%患者30例;根据病情轻重分为轻型患者70例、中间型患者8例、重型患者46例。以HPLC法测定HbA1c,以十二烷基硫酸钠(SLS)血红蛋白检测法测定血红蛋白(Hb),以毛细管电泳法测定HbA。比较α地贫、β地贫、α合并β地贫,HbA<20%、HbA20%~40%、HbA41%~60%、HbA61%~80%、HbA>80%,轻型、中间型、重型地贫患者HPLC法检测HbA1c受HbA含量影响情况;分析地贫患者HbA含量与HbA1c的相关性。结果α地贫患者HPLC法检测HbA1c受HbA含量影响率为0,β地贫患者HPLC法检测HbA1c受HbA含量影响率为41.9%(35/74),α合并β地贫患者HPLC法检测HbA1c受HbA含量影响率为37.5%(3/8),α地贫、β地贫及α合并β地贫患者HPLC法检测HbA1c受HbA含量影响率存在着统计学差异(χ^(2)=24.06,P<0.001)。轻型地贫患者HPLC法检测HbA1c受HbA含量影响率为0,中间型地贫患者HPLC法检测HbA1c受HbA含量影响率为12.5%(1/8),重型地贫患者HPLC法检测HbA1c受HbA含量影响率为71.7%(33/46),轻型、中间型、重型地贫患者HPLC法检测HbA1c受HbA含量影响率存在着统计学差异(χ^(2)=72.74,P<0.001)。HbA<20%地贫患者HPLC法检测HbA1c受HbA含量影响率为100.0%(22/22),HbA 20%~40%地贫患者HPLC法检测HbA1c受HbA含量影响率为100.0%(5/5),HbA 41%~60%地贫患者HPLC法检测HbA1c受HbA含量影响率为44.4%(4/9),HbA 61%~80%地贫患者HPLC法检测HbA1c受HbA含量影响率为0,HbA>80%地贫患者HPLC法检测HbA1c受HbA含量影响率为0,不同HbA含量地贫患者HPLC法检测HbA1c受HbA含量影响率存在着统计学差异(P<0.001)。双变量Spearman检验结果显示,HbA含量与HbObjective To investigate the effect of hemoglobin A(HbA)level on the determination of glycosylated hemoglobin(HbA1c)by high performance liquid chromatography(HPLC)in thalassemia patients.Methods There were 124 patients with thalassemia.According to thalassemia genotype,all patients were divided intoα-thalassemia patients(42 cases),β-thalassemia patients(74 cases)andαβ-thalassemia patients(8 cases).According to different HbA content,β-thalassemia patients were divided into 22 patients with HbA<20%,5 patients with HbA 20%-40%,9 patients with HbA 41%-60%,8 patients with HbA 61%-80%,and 30 patients with HbA>80%.According to the severity of the disease,there were 70 patients with mild thalassemia,8 patients with intermediate thalassemia,and 46 patients with severe thalassemia.HbA1c was determined by HPLC,hemoglobin(Hb)was determined by sodium dodecyl sulfate(SLS)and HbA was determined by capillary electrophoresis.Comparison of the rate of HbA1c affected by HbA content as measured by HPLC in a-thalassemia patients,β-thalassemia patients,αβ-thalassemia patients,thalassemia patients with HbA<20%,thalassemia patients with HbA 20%-40%,thalassemia patients with HbA 41%-60%,thalassemia patients with HbA 61%-80%,thalassemia patients with HbA>80%patients,mild thalassemia patients,intermediate thalassemia patients and severe thalassemia patients;analysis of the correlation of HbA content with HbA1c in thalassemia patients.Results The rate of HbA1c affected by HbA content as measured by HPLC method was 0 in a-thalassemia patients,41.9%(35/74)inβ-thalassemia patients and 37.5%(3/8)inαβ-thalassemia patients;there wasαstatistically significant difference in the rate of HbA1c affected by HbA content by HPLC among patients withα-thalassemia,β-thalassemia,andαβ-thalassemia(χ^(2)=24.06,P<0.001).The rate of HbA1c affected by HbA content as measured by HPLC method was 0 in mild thalassemia patients,12.5%(1/8)in intermediate thalassemia patients and 71.7%(33/46)in severe thalassemia patients;there was a statistically sign

关 键 词：地中海贫血 糖化血红蛋白 血红蛋白A 高效液相色谱法 

分 类 号：R58[医药卫生—内分泌]