糖化血红蛋白标准化和检测准确度现状

Standardization of glycated hemoglobin A_(1c) determination and its accuracy

糖化血红蛋白A_(1c)(Hb A_(1c))是诊断糖尿病和监测其治疗效果的重要指标。在国际临床化学与检验医学联合会(IFCC)定义了Hb A_(1c)的被测量之后,经过各方的努力,全球各临床实验室Hb A_(1c)检测结果间的差异正逐步减小。所有提供Hb A_(1c)检测产品的厂商都不会客观地描述自己产品的弱点,只会强调其优点和临床价值。面对Hb A_(1c)检测的现状,临床实验室必须充分了解每个产品的特性及其不足之处,在将产品用于临床检测前必须验证产品的分析性能。只有确认其分析性能能够用于临床检测时,才能使用。一个实验室内必须具备2种不同检测方法的产品,这样才能识别患者样品内有无异常血红蛋白。目前,尽管人们认为免疫学方法检测Hb A_(1c)时无异常血红蛋白的干扰,但国际上尚未从临床上对各种异常血红蛋白的影响作出客观的判断。为了患者的利益,临床实验室一定要充分了解更多的信息。

Glycated hemoglobin A_（1c）（Hb A_（1c）） is an important parameter for the diagnosis of diabetes mellitus and monitoring treatment efficiency. After Hb A1 c measurand being defined by the International Federation of Clinical Chemistry and Laboratory Medicine（IFCC）,with efforts,the differences are decreasing gradually among clinical laboratories in the world. Although Hb A1 c manufacturers introduce their instruments＇ advantages and clinical significance mainly,instead of weaknesses,clinical laboratories should know instruments＇ characteristics and disadvantages. Instruments can be used into clinical determinations,only when the analysis performances have been verified and satisfy clinical application. Every laboratory should use 2 different methods,which can identify whether there is abnormal hemoglobin or not. Although Hb A1 c can be determined by immunological methods without interference from abnormal hemoglobin,the infl uence of abnormal hemoglobin has not been defi ned. In short,clinical laboratories should learn as much information as possible for patients.