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目的研究糖尿病慢性肾脏疾病(CKD)患者的HbA1c检测受氨甲酰化血红蛋白(CHb)干扰的情况。方法收集72例CKD患者的标本,分别使用亲和层析法(Primus Ultra2)、离子交换法(VariantⅡ、HA-8160和G7)及参考(IFCC)方法检测。对正常新鲜血进行体外氨甲酰化实验。采用线性回归分析和Bland-Altman方法进行统计学分析。结果血尿素含量逐渐升高,但HbA1c值未相应增加。血红蛋白体外氨甲酰化前后的变化为:HA-8160+0.1%、VariantⅡ+0.4%、G7-0.3%和Primus Ultra2 0%。HA-8160检测值与IFCC方法测定结果最为接近,差值均值接近0,其他方法测定结果均高于IFCC方法。结论 4种方法检测HbA1c均不受CHb的干扰。
Objective To investigate the effect of carbamylated hemoglobin (CHb) on the detection of HbA1c in diabetic patients with chronic kidney disease (CKD). Methods 72 specimens of CKD were collected and tested by Primus Ultra2, ion exchange (Variant Ⅱ, HA-8160 and G7) and reference (IFCC) methods respectively. Carbamylation of normal fresh blood in vitro experiments. Linear regression analysis and Bland-Altman method were used for statistical analysis. Results The level of blood urea increased gradually, but the value of HbA1c did not increase accordingly. The changes of hemoglobin before and after carbamylation were: HA-8160 + 0.1%, VariantⅡ + 0.4%, G7-0.3% and Primus Ultra2 0%. The results of HA-8160 and IFCC are the closest, the average of the difference is close to 0, and the results of other methods are higher than that of IFCC. Conclusion The four methods to detect HbA1c are not affected by CHb.