摘要
目的:探讨血红蛋白电泳结果异常的可能原因。方法:收集成都医学院第一附属医院2018年9月至2021年7月5696例患者的血红蛋白电泳结果,并对异常结果及临床意义进行分析。结果:486例患者结果异常(占8.53%),其中300例HbA2增高,135例HbA2降低,44例单独F增高,7例有异常血红蛋白条带。486例患者中,地中海贫血基因阳性246例(阳性率50.62%),其中α地中海贫血29例,β地中海贫血208例,α合并β地中海贫血9例。在HbA2升高的患者中,68.67%为β地中海贫血引起,3.00%为α合并β地中海贫血引起,9.33%疑为红细胞体积增大引起,6.33%疑为甲状腺功能异常引起,12.67%疑为检测方法的不确定性引起。在HbA2降低的患者中,21.48%为α地中海贫血引起,60.00%为缺铁性贫血引起,8.15%疑为甲状腺功能异常引起,10.37%疑为检测方法的不确定性引起。F单独升高的患者,地中海贫血基因检测结果均为阴性,40.91%疑为红细胞体积增大引起,27.27%疑为遗传性持续性胎儿血红蛋白增多症引起,29.55%疑为部分孕妇特殊生理状况引起,2.27%疑为甲状腺功能亢进引起。7例患者检测到异常血红蛋白条带,其中4例血红蛋白D,2例血红蛋白E,1例血红蛋白J。结论:地中海贫血、缺铁性贫血、巨幼细胞性贫血与非重型再生障碍性贫血等红细胞体积增大的贫血、甲状腺功能异常、遗传性持续性胎儿血红蛋白增多症、异常血红蛋白病、检测方法的不确定性均是血红蛋白电泳结果异常的重要原因。在临床工作中应综合分析患者的各项指标来判断可能的原因。
Objective:To investigate the possible causes of abnormal hemoglobin electrophoresis results.Methods:The hemoglobin electrophoresis results of 5696 patients in the First Affiliated Hospital of Chengdu Medical College from September 2018 to July 2021 were collected,and the abnormal results and clinical significance were analyzed.Results:The results of 486 patients(accounting for 8.53%)were abnormal,of which 300 cases had increased HbA2,135cases had decreased HbA2,44 cases had increased F alone,and 7 cases had abnormal hemoglobin bands.Among the 486patients,246 patients were thalassemia gene positive(the positive rate was 50.62%),including 29 cases ofαthalassemia,208 cases ofβthalassemia and 9 cases ofαβthalassemia.Among the patients with elevated HbA2,68.67%were detectedβthalassemia,3.00%αβthalassemia,9.33%were suspected to be caused by macrocytosis,6.33%by thyroid dysfunction,and 12.67%by uncertainty of the method.Among the patients with reduced HbA2,21.48%were detectedαthalassemia,60.00%iron deficiency anemia,8.15%were suspected to be caused by thyroid dysfunction,and 10.37%by uncertainty of the method.Among the patients with elevated F alone,the results of thalassemia gene detection were negative,40.91%of them were suspected to be caused by macrocytosis,27.27%by hereditary persistence of fetal hemoglobin,29.55%by special physiological condition of pregnant women,and 2.27%by hyperthyroidism.Abnormal hemoglobin bands were detected in 7 patients,including 4 cases of hemoglobin D,2 cases of hemoglobin E,and 1 case of hemoglobin J.Conclusion:Thalassemia,iron deficiency anemia,macrocytosis such as megaloblastic anemia and nonsevere aplastic anemia,thyroid dysfunction,hereditary persistence of fetal hemoglobin,abnormal hemoglobin diseases,the uncertainty of the method are all important causes of abnormal hemoglobin electrophoresis results.In clinical work,the patient′s indicators should be comprehensively analyzed to determine the possible cause.
作者
庞雪利
杜红飞
阳燕
周晓萍
唐宁
刘佳微
许颖
PANG Xue-Lil;DU Hong-Fei;YANG Yan;ZHOU Xiao-Ping;TANG Ning;LIU Jia-Wei;XU Ying(Department of Clinical Laboratory,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan Province,China;Chengdu Medical College,Chengdu 610500,Sichuan Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2023年第3期830-836,共7页
Journal of Experimental Hematology
基金
成都医学院2018年校基金项目资助(CYZ18-19)。
