不同铁状态对血红蛋白A_2的影响

Influence of Different Iron Status on Hemoglobin A_2 Level

目的研究不同铁状态对Hb电泳时HbA2的影响,确定影响HbA2的铁临界值。方法以2008年5月-2009年5月在桂林医学院附属医院儿科门诊和产科门诊就诊的330例患者为研究对象,研究对象均进行血液学检查,免疫荧光法测定其血清铁蛋白(SF),Hb电泳并定量测定其HbA2值,珠蛋白基因检测排除常见的3种缺失型、3种点突变型α珠蛋白生成障碍性贫血和17种常见的点突变型β珠蛋白生成障碍性贫血。根据SF水平,将330例标本分为A组304例(SF≥12μg.L-1)、B组26例(SF<12μg.L-1)、C组297例(SF≥20μg.L-1)、D组33例(SF<20μg.L-1),并应用SPSS12.0软件进行统计分析。结果将4个相关组HbA2值进行比较,其中A组与B组比较(t=3.6939,P<0.05)、C组与D组比较(t=4.1517,P<0.05),差异均有统计学意义,B组与D组比较差异无统计学意义(t=0.0464,P>0.05)。结论铁缺乏会影响Hb电泳时HbA2的值,SF<20μg.L-1可以作为Hb电泳时影响HbA2的临界值,而非诊断缺铁性贫血时的SF<12μg.L-1。

Objective To study the influence of different iron status on hemoglobin A2（HbA2） level and to confirm what was the borderline of serum ferritin（SF）which affects HbA2 value.Methods Three hundred and thirty individuals,who were the outpatients of the department of pediatrics and obstetrics from May.2008 to May.2009 in the Affiliated Hospital of Guilin Medical College,were collected as research object.All the samples were tested,including blood smear,SF by immunofluorescence method,hemoglobin electrophoresis,3 types of α hemoglobin gene deletions by Multi-PCR,17 kinds point mutations of beta hemoglobin gene and 3 kinds of point mutations of α hemoglobin gene by reverse dot blot.According to their SF values,all the individuals were divided into 4 groups as group A（SF≥12 μg·L^-1,n=304）,group B（SF12 μg·L^-1,n=26）,group C（SF≥20 μg·L^-1,n=297）and group D（SF20 μg·L^-1,n=33）.Then SPSS 12.0 software was used to analyze the data.Results Those measurement data were submitted to statistical analysis.There were significant differences between group A and group B（t=3.693 9,P〈0.05）,and between group C and group D（t=4.151 7,P〈0.05）.But,there was no significant diffe-rence between group B and group D（t=0.046 4,P〈0.05）.Conclusions Iron deficiency will affect the HbA2 value.Instead of SF12 μg·L^-1,SF20 μg·L-1 can be regarded as the limitation when iron deficiency would affect the HbA2 value.