国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
4期
539-543
,共5页
血红蛋白%地中海贫血%筛查%高效液相色谱
血紅蛋白%地中海貧血%篩查%高效液相色譜
혈홍단백%지중해빈혈%사사%고효액상색보
Hemoglobin%Thalassemia%Screening%High performance liquid chromatography (HPLC)
目的 探讨离子交换高效液相色谱法(HPLC)血红蛋白分析用于地贫筛查的应用价值和基本规律.方法 收集50例血常规表型正常、151例小细胞低血素症外周全血,及7例含Hb变异体的α-地贫外周全血或脐带血标本,用VARIANTTMⅡ离子交换HPLC Hb分析系统及配套β -地贫短程序试剂进行Hb组分分析,再根据Hb分析及DNA分子诊断结果分组统计和全面评价.结果 50例正常标本HbA22.0％～4.0％、HbF＜2.0％.151例小细胞低血素症标本中,40例HbA2＞4.0％、HbF＜5.0％的标本均确诊为β-地贫基因携带者,筛查符合率100％;109例HbA2＜4.0％、HbF＜2.0％的标本中确诊108例为α-地贫；2例HbA2＜4.0％、HbF≥5.0％的标本分别确诊为δ β-地贫和HPFH.HPLC图谱显示能检出但不能定量的Hb变异体为HbH、Hb Bart's和Hb CS,不能检出Hb WS.结论 离子交换HPLC Hb分析操作简单,结果稳定可靠,人为因素影响小,适合大规模人群筛查及常规检测；并提示实践应用中,须注意特定仪器及配套试剂所采用技术的适应范围,总结经验,丰富及完善其分析数据库及色谱图,避免误诊和漏检.
目的 探討離子交換高效液相色譜法(HPLC)血紅蛋白分析用于地貧篩查的應用價值和基本規律.方法 收集50例血常規錶型正常、151例小細胞低血素癥外週全血,及7例含Hb變異體的α-地貧外週全血或臍帶血標本,用VARIANTTMⅡ離子交換HPLC Hb分析繫統及配套β -地貧短程序試劑進行Hb組分分析,再根據Hb分析及DNA分子診斷結果分組統計和全麵評價.結果 50例正常標本HbA22.0％～4.0％、HbF＜2.0％.151例小細胞低血素癥標本中,40例HbA2＞4.0％、HbF＜5.0％的標本均確診為β-地貧基因攜帶者,篩查符閤率100％;109例HbA2＜4.0％、HbF＜2.0％的標本中確診108例為α-地貧；2例HbA2＜4.0％、HbF≥5.0％的標本分彆確診為δ β-地貧和HPFH.HPLC圖譜顯示能檢齣但不能定量的Hb變異體為HbH、Hb Bart's和Hb CS,不能檢齣Hb WS.結論 離子交換HPLC Hb分析操作簡單,結果穩定可靠,人為因素影響小,適閤大規模人群篩查及常規檢測；併提示實踐應用中,鬚註意特定儀器及配套試劑所採用技術的適應範圍,總結經驗,豐富及完善其分析數據庫及色譜圖,避免誤診和漏檢.
목적 탐토리자교환고효액상색보법(HPLC)혈홍단백분석용우지빈사사적응용개치화기본규률.방법 수집50례혈상규표형정상、151례소세포저혈소증외주전혈,급7례함Hb변이체적α-지빈외주전혈혹제대혈표본,용VARIANTTMⅡ리자교환HPLC Hb분석계통급배투β -지빈단정서시제진행Hb조분분석,재근거Hb분석급DNA분자진단결과분조통계화전면평개.결과 50례정상표본HbA22.0％～4.0％、HbF＜2.0％.151례소세포저혈소증표본중,40례HbA2＞4.0％、HbF＜5.0％적표본균학진위β-지빈기인휴대자,사사부합솔100％;109례HbA2＜4.0％、HbF＜2.0％적표본중학진108례위α-지빈；2례HbA2＜4.0％、HbF≥5.0％적표본분별학진위δ β-지빈화HPFH.HPLC도보현시능검출단불능정량적Hb변이체위HbH、Hb Bart's화Hb CS,불능검출Hb WS.결론 리자교환HPLC Hb분석조작간단,결과은정가고,인위인소영향소,괄합대규모인군사사급상규검측；병제시실천응용중,수주의특정의기급배투시제소채용기술적괄응범위,총결경험,봉부급완선기분석수거고급색보도,피면오진화루검.
Objective To observe the application value and basic regularity of ion exchange high performance liquid chromatography (HPLC) hemoglobin analysis in thalassemia screening.Methods 50 peripheral full blood samples with normal RBC parameters,151 peripheral full blood samples with reduced MCV and MCH,7 peripheral full blood or cord blood samples of alpha-thalassemia with abnormal Hb were collected.All the samples were analyzed with VARIANTTM [ ion exchange HPLC Hb analysis system and its integrated β -thalassemia Short Program regent,then the evaluation was performed according to the results of Hb analysis and DNA molecular diagnosis.Results 50 normal samples were HbA2 ＜ 4.0％ and HbF ＜ 2.0％.Among the 151 peripheral full blood samples with reduced MCV and MCH,40 samples of HhA2 ＞ 4.0％ and HbF ＜ 5.0％ are all β -thalassemia carriers with the 100％ screening coincidence,109 samples ofHbA2 ＜ 4.0％ and HbF ＜ 2.0％ contain 108 αt -thalassemia carriers,2 samples of HbA2 ＜ 4.0％、HbF ≥ 5.0％ were δ β -thalassemia and HPFH respectively.HPLC figures showed that the kinds of Hb variants which can be detected but unquantified were HbH,Hb Bart's and Hb CS,the kind which can not be detected was Hb WS.Conclusion This ion exchange HPLC Hb is suitable for large scale population screening and routine detection with the advantages of simple operation,small man-made affect,stable and reliable results.It is demonstrated that we should pay attention to the application range of special instrument with its integrated regent,enrich and improve the HPLC analytic data and chromatogram,in order to avoid misdiagnosis and undetected rate by experience summary in clinical practical.
