Rumley A G, Carlton G, Small M
Department of Biochemistry, Gartnavel General Hospital, Glasgow, UK.
Diabet Med. 1990 Nov;7(9):838-40. doi: 10.1111/j.1464-5491.1990.tb01502.x.
The performance of the Diamat HPLC analyser (Bio Rad Instruments) was assessed, and the effect of this on-site HbA1 assay on the therapeutic decisions made at the diabetic clinic evaluated. The intra-assay CV for HbA1 at concentrations of 8.3 and 13.4% was 3.8 and 0.4%, respectively, with inter-assay CV of 5.0 and 3.0%. On a single day 82 HbA1 tests on consecutive patients were performed at the clinic. In 43 insulin-treated patients and 79 non-insulin-treated diabetic patients the HbA1 result changed the management decision in 25 and 18% of patients, respectively. The relationship between HbA1 and self blood glucose monitoring (SBGM) results in the previous 6-week period were also evaluated. In 41% of patients with insulin-treated diabetes who produced SBGM diaries there was a discrepancy between categories of blood glucose control, all of these patients having better SBGM than HbA1 values. This study highlights the feasibility and value of a within-clinic HbA1 assay for clinical decision-making and its usefulness in identifying problems of agreement with self-monitored tests.
对Diamat高效液相色谱分析仪（伯乐仪器公司）的性能进行了评估，并评价了这种现场糖化血红蛋白（HbA1）检测对糖尿病诊所治疗决策的影响。在糖化血红蛋白浓度为8.3%和13.4%时，批内变异系数分别为3.8%和0.4%，批间变异系数为5.0%和3.0%。在一天内，该诊所对连续的82名患者进行了糖化血红蛋白检测。在43名接受胰岛素治疗的患者和79名未接受胰岛素治疗的糖尿病患者中，糖化血红蛋白检测结果分别使25%和18%的患者的治疗管理决策发生了改变。还评估了糖化血红蛋白与前6周内自我血糖监测（SBGM）结果之间的关系。在41%提供了自我血糖监测日记的接受胰岛素治疗的糖尿病患者中，血糖控制类别存在差异，所有这些患者的自我血糖监测结果均优于糖化血红蛋白值。本研究强调了诊所内糖化血红蛋白检测用于临床决策的可行性和价值，以及其在识别与自我监测检测一致性问题方面的作用。
