Vesely D L, Sanders L L
Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock.
J Med. 1987;18(2):81-92.
Measurement of glycosylated hemoglobin (HgA1) is frequently helpful in the management of patients with diabetes mellitus as it provides an index of average glucose control over the previous two to three months. The present case of a diabetic patient with a markedly increased hemoglobin A1 to 42% (normal 5.2-9.2%) with good glucose control prompted an investigation into the etiology of the increased hemoglobin A1 levels. Hemoglobin electrophoresis revealed that the patient had hereditary persistence of fetal hemoglobin. Hemoglobin F was quantitated and found to be responsible for 73% of the hemoglobin A1 determination. Hemoglobin F co-migrates with hemoglobin A1 on column chromatography and, when present in increased quantities, can falsely elevate the measured hemoglobin A1. Thus, if one utilizes the hemoglobin A1 assay to help guide management of patients with diabetes mellitus, it is important to remember that hemoglobin F can cause falsely elevated hemoglobin A1 levels.
糖化血红蛋白（HgA1）的测定对于糖尿病患者的管理常常很有帮助，因为它提供了过去两到三个月平均血糖控制情况的指标。本病例中，一名糖尿病患者的血红蛋白A1显著升高至42%（正常范围为5.2 - 9.2%），但其血糖控制良好，这促使对血红蛋白A1水平升高的病因进行调查。血红蛋白电泳显示该患者存在胎儿血红蛋白遗传性持续存在。对血红蛋白F进行定量分析，发现其占血红蛋白A1测定值的73%。血红蛋白F在柱色谱上与血红蛋白A1共同迁移，当含量增加时，可错误地升高所测得的血红蛋白A1。因此，如果利用血红蛋白A1检测来指导糖尿病患者的管理，重要的是要记住血红蛋白F可导致血红蛋白A1水平假性升高。
