全自动多通道毛细管区带电泳技术在血红蛋白分析中的临床应用

Clinical application of fully automated multicapillary zone electrophoresis in hemoglobin analysis

目的探讨全自动多通道毛细管区带电泳技术在血红蛋白分析中的临床应用价值。方法采用法国Sebia Capillarys 2电泳系统(Version 5.50)及配套试剂,全血样品经系统自动处理后,在9.8 kV电压、34℃、pH9.4的缓冲液条件下,在8条并联的毛细管(17.5 cm×25μm)内进行血红蛋白电泳,415 nm下直接检测各组分的百分比浓度。结果分析183例健康成人血红蛋白电泳结果,确定本实验室参考范围HbA2:2.1%～3.2%。应用Hb AFSC质控进行精密度试验,各组分的CV值在(批内:0.21%～1.07%;批间:0.60%～3.10%)之间。检测6 045例临床需要进行溶血性黄疸诊断和鉴别诊断的患者标本,检出HbA_2增高379例;HbF增高203例;HbH带27例;HbE带8例;HbS带4例;Hb J-K带3例;Hb Bart′s 2例;HbD 1例。结论Sebia Capillarys 2电泳系统能够清晰分辨HbA_2、HbF增高及其他异常区带;可准确地将HbC和HbE与HbA_2区分;还可完美区分和聚焦HbA与HbS之间的HbF;并可以轻易区分移动速度相近的HbS和HbD。具有自动化程度高、操作简便、快速准确的特点,适合医疗机构临床实验室在血红蛋白分析中常规应用。

Objective To explore the applicable value of automated capillary zone electrophore- sis in hemoglobin analysis. Methods By using French Sebia Capillarys 2 electrophoresis system （Ver- sion 5.50） and related reagents, the whole blood samples were treated by the system automatically, and under the condition of 9.8 kV, 34℃, pH9.4 of buffer solution, hemoglobin electrophoresis was carried out within eight parallel capillaries （17.5 m×25μm） and the percentage concentration of each component were directly detected at 415 nm. Results By analyzing the results of hemoglobin electro- phoresis of 183 healthy adults, HbA2 reference range of our laboratory was established： 2.1%-3.2%. Precision test was performed by quality control of Hb AFSC, and CVs about each component ranged from （intra-assay： 0.21% to 1.07% ; inter-assay： 0.60% to 3.10%）. In 6 045 samples which needed diagnosis and differential diagnosis of hemolytic jaundice clinically, 379 cases were detected with high- er HbA2, 203 cases were detected with higher HbF, 27 cases were with HbH band, 8 cases with HbE band, 4 cases with HbS band, 3 cases with Hb J-K band, 2 cases with Hb Bart＇s band, and 1 case was with HbD band. Conclusion Sebia Capillarys 2 electrophoresis system can clearly distinguish higher HbAz, higher HbF and other abnormal bands; can accurately distinguish HbC from HbE and HbA2 ; can also perfectly distinguish and focalize on HbF between HbA and HbS; and can easily dis- tinguish HbS and HbD which have the close migration speed. With a high degree of automation, easy operation, rapid and accurate characteristics, it seems appropriate for conventional application of he- moglobin analysis in clinical laboratories of medical institutions.