Wong Peerapon, Weerakul Jiranun, Sritippayawan Suchila
Thalassemia Research Unit, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
Mediterr J Hematol Infect Dis. 2016 Feb 12;8(1):e2016012. doi: 10.4084/MJHID.2016.012. eCollection 2016.
In newborns and infants during their first year of life, there is a dynamic change in the fraction of hemoglobin (Hb). To apply Hb analysis as a phenotypic diagnosis of thalassemia in newborns and infants, we need normal values of each Hb fraction for reference.
Seventeen cord bloods from normal deliveries were collected for analysis. One hundred and thirty-seven infants from the pediatric outpatient clinic were recruited and were categorized by their ages into a series of short periods (month±2 weeks). Both alpha and beta thalassemia carriers detected were excluded. Samples with an Hb level less than 10.0 g/dL were also excluded. The proportion of Hb A (α2β2), A2 (α2δ2), and F (α2γ2) was obtained from high-performance liquid chromatography and analyzed according to its categorized periods.
There were 90 (58.4%) specimens left for evaluation. The percentage of Hb A, A2, and F gradually changed with increasing age. The percentage of Hb A was 21.14±7.04% (mean±SD) in cord blood and increased substantially to 83.38±1.31% at the sixth month. The level was sustained thereafter. The incremental pattern of Hb A2 was similar to Hb A. The value was 0.32±0.19% at the beginning and reached a plateau with 2.78±0.25% at the sixth month. The percentage of Hb F started at 78.39±7.59% in cord blood and decreased rapidly in the first 6 months.
The data possibly can be applied as quick guidance for interpretation of Hb analysis in newborns and infants during their first year of life.
在出生后第一年的新生儿和婴儿中，血红蛋白（Hb）各组分的比例存在动态变化。为了将Hb分析用于新生儿和婴儿地中海贫血的表型诊断，我们需要各Hb组分的正常参考值。
收集17例正常分娩的脐带血进行分析。招募了137名儿科门诊的婴儿，并根据年龄将他们分为一系列短时间段（月龄±2周）。排除检测出的α和β地中海贫血携带者。Hb水平低于10.0 g/dL的样本也被排除。通过高效液相色谱法获得Hb A（α2β2）、A2（α2δ2）和F（α2γ2）的比例，并根据其分类时间段进行分析。
有90份（58.4%）标本可供评估。Hb A、A2和F的百分比随年龄增长而逐渐变化。脐带血中Hb A的百分比为21.14±7.04%（均值±标准差），在第六个月时大幅增加至83.38±1.31%。此后该水平保持稳定。Hb A2的增加模式与Hb A相似。开始时的值为0.32±0.19%，在第六个月达到2.78±0.25%的平台期。Hb F的百分比在脐带血中起始为78.39±7.59%，在头6个月迅速下降。
这些数据可能可作为出生后第一年新生儿和婴儿Hb分析解读的快速指导。
