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

Capillary electrophoresis for glycated hemoglobin A_(1c) determination in patients with iron deficiency anemia

目的探讨缺铁性贫血(IDA)对糖化血红蛋白(Hb A_(1c))检测的影响以及毛细管电泳法检测Hb A_2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、Hb A_(1c)及Hb A_2。采用2种方案研究IDA对Hb A_(1c)检测的影响:(1)检测对照组和IDA组Hb A_(1c),分析IDA对Hb A_(1c)结果的影响;(2)采用毛细管电泳法检测Hb A_2,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、Hb A_(1c)、Hb A_2的差异。分析毛细管电泳法检测对照组和IDA组的Hb A_2结果,通过受试者工作特征(ROC)曲线建立毛细管电泳法Hb A_2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Hb A_(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、Hb A_(1c)及Hb A_2结果差异均有统计学意义(P<0.01)。毛细管电泳法Hb A_2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Hb A_(1c)的检测会产生一定的影响。毛细管电泳法在检测Hb A_(1c)的同时还能提供Hb A_2结果,可用于筛查IDA。

Objective To investigate the influence of iron deficiency anemia（IDA） on glycated hemoglobin A_（1c）（Hb A_（1c））determination and the application of capillary electrophoresis in the determination of hemoglobin A_2（Hb A 2）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, Hb A_（1c） and Hb A_2 were determined. Using 2 plans,the influence of IDA on Hb A_（1c） determination was evaluated.（1）The influence of IDA on the results of Hb A_（1c） determination was evaluated.（2）Hb A_2 was determined by capillary electrophoresis, and the differences of hemoglobin（Hb）,mean corpuscular volume（MCV）,mean corpuscular hemoglobin（MCH）,ferritin, Hb A_（1c） and Hb A_2 before and after treatment were compared. The Hb A_2 results in control and IDA groups by capillary electrophoresis were analyzed. The cut-off values of Hb A_2 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 Hb A_（1c） showed statistical significance between control and IDA groups（P〈0.05）. In IDA group,Hb,MCV,MCH,ferritin,Hb A_（1c） and Hb A_2 had statistical significance between before and after treatment（P〈0.01）. When the cut-off value of Hb A_2 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 Hb A_（1c） determination. Capillary electrophoresis can determine Hb A_（1c） and Hb A_2 simultaneously,which can be used into IDA screen.