糖化血红蛋白测定及临床意义

目的了解糖化血红蛋白检测及临床意义,以便更好地服务于临床,帮助糖尿病患者控制血糖水平。方法用全自动生化仪检测血糖,Drew-DS5分析仪测定HbAlc含量。结果糖尿病患者181例HbAlc含量（8.42±2.59）%,正常对照组110例HbAlc含量（4.62±0.76）%。糖尿病组HbAlc含量明显增高（P〈0.001）。结论血浆中糖化血红蛋白测定对糖尿病患者诊断及治疗具有重要意义。     

糖化血红蛋白在糖尿病诊治中的重要性探讨

糖化血红蛋白是一项说服力强、数字较客观、稳定性较好的生化检查。目前糖化血红蛋白作为糖尿病流行病学研究和疗效考核的有效检测指标,在临床中得到广泛使用。最具权威的两大糖尿病临床研究,美国1型糖尿病控制及并发症试验(DC-CT)和英国2型糖尿病控制与并发症研究(UKPDS)均把糖化血红蛋白作为糖尿病控制的一个重要评价指标。因此,充分了解糖化血红蛋白在糖尿病诊治中的重要性是非常必要的,总结如下。1糖化血红蛋白(1)糖化血红蛋白是血中葡萄糖与红细胞的血红蛋白经过非酶缩合而形成的产物,其主要形式为HbA 1c,此外尚有HbA 1a1、HbA 1…     

糖化血红蛋白在糖尿病诊治中的应用价值

糖化血红蛋白（HbAlc）近年已被公认为糖尿病长期血糖控制的有效指标，我院近年来对80例糖尿病患者进行了糖化血红蛋白的测定，并与正常人进行了对照分析，现总结如下。     

糖化血红蛋白检测在糖尿病诊治中的作用

目的 探讨糖化血红蛋白(HbAlc)在糖尿病(DM)诊治中的价值.方法 以免疫荧光分析法测定68例DM患者不同治疗阶段的HbAlc,并与健康对照组比较.结果 DM患者HbAlc不但与对照组差异有统计学意义(P<0.01),且治疗6周后下降明显,10周后接近正常水平.结论 HbAlc对DM的早期诊断和疗效评估有重要的意义.     

两种POCT检测系统测定糖化血红蛋白对比分析

目的 比较两种即时检验(POCT)方法测定糖化血红蛋白(HbA1c)结果的一致性并作偏倚评估.方法 使用两种方法分别测定42例血液标本HbA1c水平,并与高效液相色谱法测定结果进行相关性分析;应用质控品和定值参考物质作精密度和偏倚评估.结果 两种POCT分析仪与HPLC法测定糖化血红蛋结果相关性良好,P＜0.05;平均批内、批间CV%:Afinion AS100为1.0%、1.8%;NycoCard ReaderⅡ为3.7%、4.6%;与参考物靶值比较,相对偏倚分别为1.8%、4.35%.结论 Afinion AS100与NycoCard ReaderⅡ分析仪测定HbA1c变异系数差别较大,应以HPLC法作为参考方法,定期对仪器进行校准.     

糖化血红蛋白在糖尿病诊断和治疗中的价值

目的探讨糖化血红蛋白（HbAIc）在糖尿病诊断以及治疗中的临床价值。方法选择98例确诊为糖尿病的受检者以及120例健康人群禁食10～12 h,测定空腹血糖（FPG）、餐后2 h血糖（2hPG）及测定糖化血红蛋白（HbAIc）。结果糖尿病组的血糖及糖化血红蛋白均明显高于正常对照组（P〈0.01）;糖尿病并发症的发生率随HbAIc水平升高而升高（P〈0.01）。结论 HbA1c与FPG、2hPG联合监测作为筛选诊断DM并指导治疗较好适合的方法且简单、便捷、可重复性好的敏感指标。     

急性脑梗死与糖化血红蛋白的相关性分析

对急性脑梗死与糖化血红蛋白的相关性分析如下。1对象和方法1.1对象选择2003-01~2007-01本院神经内科住院发病4h内急性脑梗死合并血糖增高患者60例,其中男35例,女2例,年龄51~79岁,平均63.5岁。1.2方法患者发病后48 h内用葡萄糖氧化酶法测定空腹静脉血糖,若空腹血糖高出正常值(3.6~6.1 mmol/L)则入选为观察对象,并对此用挪威Nycocard Reader型金标定量仪行定量金标法测定。按测量值分为二组:甲组(测得HBA1c值在正常范围4.5~6.3%)和乙组(测得HBA1c值>6.3%)两组。住院期间均采取内科活血化瘀治疗。观察两组患者入院时及入院后第4周末的神经…     

糖尿病100例糖化血红蛋白的检测结果分析

目的:通过对100例糖尿病患者的糖化血红蛋白检测结果进行分析,探讨该项目在糖尿病诊断及治疗中的应用及其临床价值。方法:采用免疫比浊法。结果:100例糖尿病患者的糖化血红蛋白检测结果在正常参考范围内4%～6%有20例;在6%～10%有61例;在10%以上有19例。通过统计,有19%糖尿病患者血糖控制未达到标准。结论:糖化血红蛋白可以作为糖尿病患者血糖水平监测和调整治疗方案的重要指标,具有重要的临床意义和使用价值。     

糖化血红蛋白与巨大儿

【目的】了解糖化血红蛋白（GHb）在妊娠期糖尿病（GDM）与巨大儿的关系，以更好指导临床地制定糖尿病患者的诊疗方案。【方法】用HbAlc方法对GDM的孕妇每2个月检查一次GHb检测，正常参考值为5．89±0．9％（4．99％～6．79％）〉6％为异常。【结果】GHb能反映采血前两个月的平均血糖水平；GDM的GHb与巨大儿成正比。GHb正常组与GHb为异常组差异有显著性（P〈0．05）。【结论】GDM的GHb与巨大儿成正比，是监测糖尿病控制的金标准。     

糖化血红蛋白检测方法的实验室评价及临床应用

糖尿病是以血糖升高为表现的代谢性疾病,长期高血糖状态会造成患者组织和器官慢性损害,导致系统机能障碍。糖化血红蛋白(GHb)是人体血液中红细胞内血红蛋白与葡萄糖通过非酶促缓慢、持续且不可逆结合而形成的一种血红蛋白组分。HbA1c是GHb的一种亚型,约占人总血红蛋白的5%,是GHb各组分中最具有特征的,同时也是目前研究的最广泛的糖尿病监测指标。     

糖化血红蛋白检测在糖尿病诊治中的临床意义

目的：探讨糖化血红蛋白检测对糖尿病患者诊断、血糖控制及疗效评价的临床意义。方法：对我院近年来诊治的2型糖尿病患者79例的临床资料进行回顾性对比分析。结果：糖尿病患者空腹血糖及HbA1C均明显高于健康对照,且空腹血糖水平越高HbA1C含量越高,糖化血红蛋白和空腹血糖之间呈正相关关系。结论：糖化血红蛋白检测对糖尿病诊断、血糖控制及疗效评价有重要临床意义。     

糖化血红蛋白和尿微量白蛋白联合检测与早期糖尿病肾病的关系

糖尿病肾病（DN）现已成为终末期肾病的主要原因之一,在我国终末期肾病患者中DN约占15%。糖化血红蛋白（HbAlc）是衡量血糖控制情况的重要指标。尿微量自蛋白（U—ALB）是糖尿病肾脏微血管损害的检测指标。笔者通过对120例尿常规尿蛋白阴性糖尿病患者进行HbAlc、u—ALB及空腹血糖（FBG）进行检测,探讨其在DN早期诊断中的意义。     

Pathogenesis of Hemolytic Anemia in Homozygous Hemoglobin C Disease

Hemoglobin C is less soluble than hemoglobin A in red cells, in hemolysates, and in dilute phosphate buffer. Its relative insolubility may be explained by electrostatic interactions between positively charged beta6-lysyl groups and negatively charged groups on adjacent molecules. Red cells from patients with homozygous hemoglobin C (CC) disease exhibit aberrant physical properties which suggest that the cells are more rigid than normal erythrocytes. They pass through membrane filters less readily than normal red cells do, and their viscosity is higher than that of normal cells. Differences from normal cells are exaggerated if mean corpuscular hemoglobin concentration (MCHC) is increased, by suspension in hypertonic salt solution. Increased rigidity of CC cells, by accelerating their fragmentation, may be responsible for formation of microspherocytes. These small dense cells are exceptionally rigid, and probably are even more susceptible to fragmentation and sequestration. Rigidity of CC cells can be attributed to a "precrystalline" state of intracellular hemoglobin, in which crystallization does not occur, although the MCHC exceeds the solubility of hemoglobin in hemolysates.     

Quinidine Hemolytic Anemia in the Absence of Thrombocytopenia in a Patient with Hemoglobin D

A patient on quinidine therapy was found to have a positive direct Coombs test and low grade hemolytic anemia without thrombocytopenia. The serum and red cell eluates contained an antibody which reacted by indirect Coombs technic against red cells presensitized with quinidine gluconate. The serum also contained weak anti‐Sd^a. The hemolytic anemia, anti‐Sd^a, and positive direct Coombs test disappeared three months after the drug was discontinued. The serologic findings are described. An incidental finding of hemoglobin D is also noted, and its relationship to the hemolysis is considered.     

Hemoglobin Catabolism Following a Hemolytic Transfusion Reaction in a Patient with Sickle Cell Anemia

A hemolytic transfusion reaction occurring in a patient with sickle cell anemia provided insight into the handling of massive amounts of hemoglobin in patients who lack haptoglobin. Despite the acute intravascular release of 33 gms of hemoglobin, the peak plasma hemochromogen was only 134 mg/100 ml and only 6 per cent of the hemoglobin load was recovered in the urine. In contrast, the serum bilirubin rose sharply to a peak of 30 mg/100 ml within three hours of hemolysis.
The minimal hemoglobinuria, the relatively low peak level of plasma hemoglobin, and the marked and rapid elevation of serum bilirubin suggest an increased hemoglobin clearing capacity of the chronically stimulated reticuloendothelial system in patients with chronic severe hemolytic disease.     

Stability of Peroxide Antimalarials in the Presence of Human Hemoglobin

Peroxide antimalarials, including artemisinin, are important for the treatment of multidrug-resistant malaria. These peroxides are known to react with iron or heme to produce reactive intermediates that are thought to be responsible for their antimalarial activities. This study investigated the potential interaction of selected peroxide antimalarials with oxyhemoglobin, the most abundant form of iron in the human body. The observed stability of artemisinin derivatives and 1,2,4-trioxolanes in the presence of oxyhemoglobin was in contrast to previous reports in the literature. Spectroscopic analysis of hemoglobin found it to be unstable under the conditions used for previous studies, and it appears likely that the artemisinin reactivity reported in these studies may be attributed to free heme released by protein denaturation. The stability of peroxide antimalarials with intact oxyhemoglobin, and reactivity with free heme, may explain the selective toxicity of these antimalarials toward infected, but not healthy, erythrocytes.Peroxide antimalarials are becoming increasingly important for the control of Plasmodium falciparum malaria in the current landscape of multidrug resistance to conventional drugs, such as chloroquine and mefloquine (22). Currently, artemisinin-based combination therapy is the recommended first-line treatment for malaria (22), a disease that affects approximately 500 million people each year, predominantly in developing countries (31). The widespread utilization of artemisinin-based therapies is impacted by cost and logistical issues arising from sourcing the naturally derived artemisinin, leading to a major focus on the development of novel synthetic peroxides to provide new treatment options (13). The dispiro-1,2,4-trioxolane OZ277 (also known as {"type":"entrez-protein","attrs":{"text":"RBx11160","term_id":"1426628445","term_text":"RBX11160"}}RBx11160) (Fig. ​(Fig.1)1) is an example of the potential for development of a fully synthetic antimalarial based on the peroxide pharmacophore (36).Open in a separate windowFIG. 1.Structures of artemisinin (ART), DHA, AM, and the 1,2,4-trioxolanes OZ78 and OZ277.The precise mechanism of action of peroxide-based antimalarials remains a matter of debate (9, 15, 19, 23, 29); however, they are thought to exert their antimalarial activities via a mechanism involving iron-mediated peroxide bond cleavage to release reactive intermediates (19, 23). The biological sources of iron within the infected erythrocyte that may induce this activation include free inorganic iron, free heme, and intact hemoglobin (Hb) (23, 29, 39). Furthermore, the potential for peroxides to react with intact Hb in healthy erythrocytes may influence the pharmacokinetic and/or toxicological profiles of these peroxide antimalarials.The reaction of artemisinin with Hb has previously been studied by a variety of techniques to investigate the mechanism(s) and kinetics of interaction. These studies suggested reduction of the peroxide bond by the bound heme moiety of Hb, resulting in either decreased artemisinin concentration (1) or potency (28), Hb degradation (21), or alkylation of globin (38) or heme (14, 30). Inconsistencies are apparent among these findings and are suggested to result from variations in the Hb oxidation state and conformational stability (21). The oxidation state of the heme iron centers in Hb can shift between the Fe(II) and Fe(III) states and may be five coordinate or bind ligands at the sixth coordination site (e.g., oxygen). In the biological setting, the predominant form is oxyHb, which is in the oxygen-bound Fe(II) state. Ex vivo, oxyHb is easily oxidized to form metHb, which readily undergoes denaturation to release heme and form insoluble hemichromes (10, 18, 34). Furthermore, the redox state and protein conformation of oxyHb are highly dependent on changes to solvents, buffers, and temperature (11, 12, 24, 34). Conformational instability and release of heme from metHb (3, 10, 16, 18) and oxyHb (12) solutions may significantly influence in vitro reactivity studies, and these studies may not accurately reflect the nature of intracellular oxyHb, which has a stabilized quaternary structure. A recent study has demonstrated instability of oxyHb in solution, irrespective of the presence of artemisinin, concluding that no artemisinin-specific reaction occurred with Hb under standard reaction conditions at 37°C in phosphate buffer (39). A major limitation faced by many of these studies was the inability to directly monitor the concentration of artemisinin, which may still undergo catalytic cleavage by Hb without directly mediating Hb degradation.The purpose of the present study was to simultaneously measure the concentrations of both oxyHb and the peroxide antimalarial under reaction conditions that minimize background Hb oxidation and degradation. A combination of liquid chromatography-mass spectrometry (LC-MS) and visible spectroscopy allowed a kinetic analysis of artemisinin degradation while also monitoring Hb stability, the oxidation state, and ligand binding. The investigation also utilized two clinically used semisynthetic artemisinin derivatives, dihydroartemisinin (DHA) and artemether (AM), and two 1,2,4-trioxolanes, OZ78 and OZ277. All experiments were conducted under identical conditions to allow a direct comparison between these two structurally distinct groups of peroxide antimalarials.     

新生儿溶血病血清学检查分析

我院近几年对新生儿病区收治新生儿黄疸患儿进行了血清学检查分析，现报告如下。 1 对象和方法 1．1 对象 我院新生儿病区收治的黄疸患儿82例，出生1h～7d，男婴46例，女婴36例。有母婴血型不合，早期有高黄疸和溶血表现，临床初步诊断为新生儿溶血病，遂抽取患儿及母亲的血标本送我室进行血清学分析。     

新生儿ABO溶血病的检测与分析

本研究了解新生儿ABO溶血病（ABO-HDN）的发病率、血型模式并对溶血三项检测结果进行分析,为临床诊断及治疗提供依据.选择2013年1月至2013年10月本院及外院送检的母婴ABO血型不合病例227例,检测患儿及母亲的ABO血型及新生儿的溶血病三项试验（直接抗人球蛋白试验、游离抗体试验、红细胞抗体释放试验）.结果表明,新生儿ABO溶血病共186例,占所有病例的81.94％ （186/227）,O-A与O-B两种母婴血型模式的发病率经卡方检验P＞0.05.186例阳性病例中,直接抗人球蛋白试验阳性者占59.14％ （110/186）,游离抗体试验阳性者占84.78％ （156/186）,红细胞抗体释放试验阳性者占94.62％ （176/186）.结论：新生儿ABO溶血病发病率高,以母亲O型、患儿A/B型为主,O-A与O-B两种母婴血型模式的发病率的差异无显著性意义.溶血三项试验敏感性高,对新生儿溶血病的早期诊断、早期治疗起着非常积极的作用.     

免疫性溶血性输血反应100例分析

目的 近年来,临床样本的检测中,免疫性溶血性输血反应(IHTR)样本检出率不断增加.同时,毛细管离心技术、PEG增强技术、微柱凝集卡技术等逐渐普及应用,这些技术上的变化可能影响IHTR检出率.为了减少IHTR漏检,有必要对以往IHTR样本特点进行总结,分析造成临床漏检的可能原因,以及实验室及时发现IHTR的检测技术关键...     

自身免疫性溶血性贫血36例临床分析

目的研究自身免疫性溶血性贫血(AIHA)的临床特征。方法对36例AIHA的临床资料进行回顾性分析。结果发病年龄以青壮年为主,且女性多于男性;36例中病因明确者19例(52.8%),其中系统性红斑狼疮6例(31.6%);免疫分型以IgG+C3型多见,余依次为C3型、IgG型;C3型溶血、贫血程度最轻,IgG+C3组次之,含IgA或IgM组溶血、贫血程度最严重;C3型对激素反应效果最好,IgG+C3组次之,含IgM或IgA组疗效最差。结论AIHA免疫分型与临床特征及治疗效果相关,可为临床治疗提供依据。