通过高效液相色谱法测得的糖化血红蛋白值极低时相关的情况。
Conditions associated with very low values of glycohaemoglobin measured by an HPLC method.
作者信息
Camargo J L, Gross J L
机构信息
Clinical Pathology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
出版信息
J Clin Pathol. 2004 Apr;57(4):346-9. doi: 10.1136/jcp.2002.007088.
AIMS
To identify the causes of very low glycohaemoglobin (GHb) values in a sample of patients with diabetes in southern Brazil using high performance liquid chromatography.
METHODS
Between August 1996 and December 2001 all samples from patients with diabetes at a university hospital with GHb values below the reference range (4.7-6.0% HbA(1c)) were submitted to cellulose acetate electrophoresis. Medical records were reviewed to identify conditions that might be associated with these low values.
RESULTS
Among 29 657 samples analysed, 130 patients had GHb < 4.7%. Seventy three patients (56%) were heterozygous for HbS, HbC, or HbD (19 black, two mulatto, and 52 white patients). The other 57 patients (44%) without Hb variants had low haematocrit and haemoglobin values (42 patients) or other conditions such as pregnancy, lipaemia, malignancy, cirrhosis, acetylsalicylic acid use, and absence of diabetes (15 patients).
CONCLUSIONS
The presence of an Hb variant may falsely lower GHb measurements. However, anaemia is also a source of negative interference. The haematological status should be considered for the correct interpretation of GHb results.
目的
使用高效液相色谱法确定巴西南部糖尿病患者样本中糖化血红蛋白（GHb）值极低的原因。
方法
1996年8月至2001年12月期间，大学医院中糖化血红蛋白值低于参考范围（4.7 - 6.0% HbA₁c）的所有糖尿病患者样本均进行醋酸纤维素电泳。查阅病历以确定可能与这些低值相关的情况。
结果
在分析的29657个样本中，130名患者的糖化血红蛋白<4.7%。73名患者（56%）为HbS、HbC或HbD的杂合子（19名黑人、2名混血儿和52名白人患者）。其他57名无血红蛋白变异的患者血细胞比容和血红蛋白值较低（42名患者），或有其他情况，如妊娠、脂血症、恶性肿瘤、肝硬化、使用乙酰水杨酸以及非糖尿病患者（15名患者）。
结论
血红蛋白变异体的存在可能会错误地降低糖化血红蛋白测量值。然而，贫血也是负干扰的一个来源。为正确解读糖化血红蛋白结果，应考虑血液学状态。
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