毛细管电泳法糖化血红蛋白检测系统在缺铁性贫血患者中的应用

doi:10.3969/j.issn.1673-8640.2016.04.012

摘要/Abstract

摘要：

目的探讨缺铁性贫血（IDA）对糖化血红蛋白（HbA_1c）检测的影响以及毛细管电泳法检测HbA₂在IDA中的应用。方法收集IDA确诊患者79例,以79名血常规和铁蛋白均正常者作为对照组。分别检测2个组的空腹血糖、糖化血清蛋白、铁蛋白、HbA_1c及HbA₂。采用2种方案研究IDA对HbA_1c检测的影响：（1）检测对照组和IDA组HbA_1c,分析IDA对HbA_1c结果的影响;（2）采用毛细管电泳法检测HbA₂,比较IDA患者治疗前后各项血液学指标[包括血红蛋白（Hb）、红细胞平均体积（MCV）、平均红细胞血红蛋白含量（MCH）]及铁蛋白、HbA_1c、HbA₂的差异。分析毛细管电泳法检测对照组和IDA组的HbA₂结果,通过受试者工作特征（ROC）曲线建立毛细管电泳法HbA₂筛查IDA的临界值。结果对照组和IDA组空腹血糖和糖化血清蛋白差异均无统计学意义（P均>0.05）,而铁蛋白和HbA_1c结果差异均有统计学意义（P<0.05）。IDA组治疗前后Hb、MCV、MCH、铁蛋白、HbA_1c及HbA₂结果差异均有统计学意义（P<0.01）。毛细管电泳法HbA₂筛查IDA的临界值为2.25%,敏感性为93.4%,特异性为92.1%。结论 IDA对HbA_1c的检测会产生一定的影响。毛细管电泳法在检测HbA_1c的同时还能提供HbA₂结果,可用于筛查IDA。

关键词: 糖化血红蛋白, 血红蛋白A2, 毛细管电泳法, 缺铁性贫血

Abstract:

Objective To investigate the influence of iron deficiency anemia （IDA） on glycated hemoglobin A_1c （HbA_1c）determination and the application of capillary electrophoresis in the determination of hemoglobin A₂（HbA₂）for the diagnosis of IDA. Methods A total of 79 patients with IDA were enrolled,and 79 subjects with normal blood routine test results and ferritin were enrolled as control group. Fasting blood glucose, glycated serum protein,ferritin, HbA_1c and HbA₂ were determined. Using 2 plans,the influence of IDA on HbA_1c determination was evaluated.（1）The influence of IDA on the results of HbA_1c determination was evaluated.（2）HbA₂ was determined by capillary electrophoresis, and the differences of hemoglobin（Hb）,mean corpuscular volume（MCV）,mean corpuscular hemoglobin（MCH）,ferritin, HbA_1c and HbA₂ before and after treatment were compared. The HbA₂ results in control and IDA groups by capillary electrophoresis were analyzed. The cut-off values of HbA₂ by capillary electrophoresis for IDA were assessed by receiver operating characteristic （ROC） curve. Results Fasting blood glucose and glycated serum protein showed no statistical significance between control and IDA groups（P>0.05）. Ferritin and HbA_1c showed statistical significance between control and IDA groups（P<0.05）. In IDA group,Hb,MCV,MCH,ferritin,HbA_1c and HbA₂ had statistical significance between before and after treatment（P<0.01）. When the cut-off value of HbA₂ by capillary electrophoresis for IDA screen was 2.25%,the sensitivity was 93.4%,and the specificity was 92.1%. Conclusions IDA has certain effect on HbA_1c determination. Capillary electrophoresis can determine HbA_1c and HbA₂ simultaneously,which can be used into IDA screen.

Key words: Glycated hemoglobin A1c, Hemoglobin A2, Capillary electrophoresis, Iron deficiency anemia

中图分类号:

R446.1

徐安平, 纪玲, 陈卫东, 夏勇, 喻晶, 周宇, 李璐. 毛细管电泳法糖化血红蛋白检测系统在缺铁性贫血患者中的应用[J]. 检验医学, 2016, 31(4): 299-303.

XU Anping, JI Ling, CHEN Weidong, XIA Yong, YU Jing, ZHOU Yu, LI Lu. Capillary electrophoresis for glycated hemoglobin A_1c determination in patients with iron deficiency anemia[J]. Laboratory Medicine, 2016, 31(4): 299-303.

图/表 4

参考文献 20

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组别	例数	空腹血糖（mmol/L）	糖化血清蛋白（μmol/L）	铁蛋白（ng/mL）	HbA₂（%）	毛细管电泳法 HbA_1c（%）	HPLC HbA_1c（%）
对照组	79	5.04±0.30	206.4±17.70	49.38±30.53	2.56±0.21	4.91±0.32	4.83±0.30
IDA组	79	5.00±0.30	210.9±19.90	3.91±1.60^*	1.83±0.26^*	5.06±0.40^*	4.95±0.38^*

组别	例数	空腹血糖（mmol/L）	糖化血清蛋白（μmol/L）	铁蛋白（ng/mL）	HbA₂（%）	毛细管电泳法 HbA_1c（%）	HPLC HbA_1c（%）
对照组	79	5.04±0.30	206.4±17.70	49.38±30.53	2.56±0.21	4.91±0.32	4.83±0.30
IDA组	79	5.00±0.30	210.9±19.90	3.91±1.60^*	1.83±0.26^*	5.06±0.40^*	4.95±0.38^*

组别	例数	Hb（g/L）	MCV（fL）	MCH（Pg）	铁蛋白（ng/mL）	HbA₂（%）	毛细管电泳法 HbA_1c（%）	HPLC HbA_1c （%）
治疗前	33	86.8±19.10	73.1±8.10	21.0±3.80	4.59±1.88	1.79±0.24	4.92±0.38	4.89±0.45
治疗后	33	116.96±10.20^*	82.5±4.80^*	25.4±2.30^*	12.00±6.96^*	2.14±0.10^*	4.56±0.37^*	4.59±0.40^*

组别	例数	Hb（g/L）	MCV（fL）	MCH（Pg）	铁蛋白（ng/mL）	HbA₂（%）	毛细管电泳法 HbA_1c（%）	HPLC HbA_1c （%）
治疗前	33	86.8±19.10	73.1±8.10	21.0±3.80	4.59±1.88	1.79±0.24	4.92±0.38	4.89±0.45
治疗后	33	116.96±10.20^*	82.5±4.80^*	25.4±2.30^*	12.00±6.96^*	2.14±0.10^*	4.56±0.37^*	4.59±0.40^*

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