地中海贫血对糖化血红蛋白测定的影响

目的探讨地中海贫血对糖化血红蛋白(HbA1c)测定的影响。方法选择本院符合WHO糖尿病(DM)诊断标准的患者96例,通过血红蛋白电泳结果分为地贫DM组28例和非地贫DM组68例。分别测定血红蛋白(Hb)、红细胞平均体积(MCV)、网织红细胞(Ret)、HbA1c、总胆红素(TBil)、直接胆红素(DBil)、空腹血糖(FBG)。间接胆红素(IBil)由计算可得。并将所得数据进行统计学分析。结果地贫DM组Hb、MCV和HbA1c都比非地贫DM组低([113±23)比(122±16)g/L,(73±5)fl比(89±4)fl,(8±4)%比(11±4)%],IBil和Ret比非地贫DM组高([11±6)比(6±3)mmol/L,(1.0±0.6)%比(0.7±0.4)%],两组间差异有统计学意义。非地贫DM组FBG与HbA1c呈正相关(r=0.894,P<0.01),而地贫DM组FBG与HbA1c无明显相关性(P>0.05)。结论对于地贫患者,HbA1c未必能正确反映其血糖控制情况,应以多种方法进行血糖监测评价。

Objective To study the influence of the mediterranean anemia on determination of glycated hemoglobin （HbAlc） . Methods Ninety-six patients comply with diabetes mellitus （DM） diagnosis standard were chosen, the patients were divided into the mediterranean anemia DM group （28 cases）and non-mediterranean anemia DM group （68 cases） by hemoglobin electrophoresis results. Hemoglobin （Hb）, red blood cell volume average （MCV）, net to knit red blood cells （Ret）, HbA1 c, total bilirubin （TBil）, direct bilirubin （DBil）, fasting blood sugar （FBG） were determined. Indirect bilirubin （IBil） can be got by calculation. Then the data were statistics analyzed. Results Hb,MCV and HbAlc in mediterranean anemia DM group than non-editerranean anemia DM group[（ 113±23）vs（ 122±16）g/L, （73±5）fl vs（89±4）fl, （8±4）% vs（ 11±4）%], and IBil and Ret in the mediterranean anemia DM group than that in the non-mediterranean anemia DM group[ （11±6）vs （6±3）retool/L, （ 1.0±0.6） % vs（0.7±0.4）%] ,there was significant difference between the two groups. The FBG was with a positive correlation with HbAlc in non-mediterranean anemia DM group （P 〈 0.01）, and FBG and HbA 1 c in the mediterranean anemia DM group had no significant correlation （P〉0.05）. Conclusion For the mediterranean anemia patients ,HbAlc may not be accurately reflects their blood sugar control, should be in a number of ways for blood sugar monitoring and evaluation.