To determine the types and proportion of common hemoglobin variants in Tianjin and surrounding areas, to analyze the recognition ability and the effects of hemoglobin variants on experimental results in two commonly used glycated hemoglobin systems, so as to provide data support for the consistency of HbA1c detection in Tianjin City. A case-control study was used for retrospective analysis,156 specimens with abnormal electrophoretic peaks in the detection of glycated hemoglobin were collected from more than 50 000 specimens of patients in Chu Hsien-I Memorial Hospital of Tianjin Medical University between June 2020 and December 2020. Determined their hemoglobin mutation sites by DNA sequencing, and compared the values of hemoglobin variants on glycated hemoglobin detection values by high performance liquid chromatography and capillary electrophoresis. SPSS 23 was used to calculate the blood routine results of the variant specimens, and compared with the normal reference interval. The results showed that DNA sequencing identified 21 hemoglobin variants, of which 11 were α strand variants and 10 were β strand variants. In addition, an unreported hemoglobin variant was identified, Hb Headington (HBB: c.217A>C). The HbA1c of 11 variants including Hb G-Honolulu, Hb Queens, Hb Q-Thailand, Hb J-Broussais, Hb O-Indonesia, Hb G-Coushatta, Hb G-Taipei, Hb E, Hb Headington, Hb New York and Hb D-Los Angeles were shifted by more than 7% when measured by high-performance liquid chromatography. Patients with the Hb Q-Thailand and Hb E cause reduced MCV and MCH. In conclusion, an unreported hemoglobin variant was found from Tianjin and neighboring areas. Patients with the Hb Q-Thailand and Hb E cause reduced MCV and MCH. 11 of these hemoglobin variants interfered with the detection of glycated hemoglobin using high-performance liquid chromatography, resulting in inaccurate results.
探讨天津及周边地区常见血红蛋白变异体的种类和占比,分析两种常用糖化血红蛋白检测系统对这些血红蛋白变异体的识别能力和对糖化血红蛋白检测结果的影响,为天津地区糖化血红蛋白检测的一致性提供实验数据支持。采用病例对照研究,进行回顾性分析,从2020年6至12月期间在天津医科大学朱宪彝纪念医院就诊的天津及周边地区患者的5万多例标本中,收集毛细管电泳法检测糖化血红蛋白时出现异常电泳峰的标本156例。通过DNA测序确定其血红蛋白突变位点。比较高效液相色谱法和毛细管电泳法测得的变异体糖化血红蛋白值。利用SPSS 23计算变异体标本血常规结果,并与正常参考区间进行比较,分析血红蛋白变异体对红细胞相关参数的影响。结果显示,DNA测序发现了21种血红蛋白变异体,其中11种为α链变异体,10种为β链变异体。其中,1种为未曾报道的血红蛋白变异位点,Hb Headington(HBB:c.217A>C)。高效液相色谱法和毛细管电泳法测定结果比较发现,Hb G-Honolulu、Hb Queens、Hb Q-Thailand、Hb J-Broussais、Hb O-Indonesia、Hb G-Coushatta、Hb G-Taipei、Hb E、Hb Headington、Hb New York和Hb D-Los Angeles 11种变异体糖化血红蛋白结果偏移大于7%。血细胞分析发现,Hb Q-Thailand变异体患者和Hb E变异体患者平均血细胞比容(mean corpuscular volume,MCV)和平均红细胞血红蛋白含量(mean corpuscular hemoglobin,MCH)减低。综上,天津及周边地区患者存在新的血红蛋白变异位点突变体,Hb Q-Thailand变异体患者和Hb E变异体患者MCV和MCH减低,11种血红蛋白变异体会干扰离子高效液相色谱法对糖化血红蛋白检测的准确性。.