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目的探讨免疫比浊法检测糖化血红蛋白(Hb A1c)在生化检验及临床中的局限性及实际应用。方法 200份体检标本(A1组),及已确诊的糖尿病患者标本100份(B1组)均检测Hb A1c,将该项目标定后再次检测Hb A1c分为A2组与B2组。均在Hb A1c重新定标前、后分别检测并同时检测血糖。结果 A1组与A2组、B1组与B2组Hb A1c结果相比差异有统计学意义(P<0.05),A1、B1组中分别有49%和37%的假性增高,整体结果偏高;B2组中Hb A1c增高者41例,血糖增高者35例,疑似糖尿病未控制或控制不良;A2组12例血糖增高而Hb A1c正常,其中9例疑似刚发现的糖尿病患者;7例Hb A1c假性增高。结论免疫比浊法查Hb A1c的结果很不稳定,不能较准确的反映患者8周前的血糖水平。提醒临床医生应将此结果仅作为参考,对新发现的和未控制及糖尿病患者的治疗监测做出正确评估。
Objective To investigate the limitations of biochemical test and clinical application of immunoturbidimetry in detecting hemoglobin A1c (Hb A1c) and its clinical application. Methods Hb A1c was detected in 200 physical examination specimens (group A1) and 100 specimens of diabetics (group B1). After the test, Hb A1c was divided into group A2 and group B2. Before Hb A1c re-calibration, respectively, after testing and simultaneous detection of blood glucose. Results There were significant differences in the results of Hb A1c between group A1 and group A2, group B1 and group B2 (P <0.05), and the false positives of 49% and 37% in group A1 and B1 were higher respectively, and the overall results were higher. B2 group Hb A1c increased in 41 cases, 35 cases of hyperglycemia, suspected diabetes was not controlled or poor control; A2 group of 12 cases of elevated blood glucose and Hb A1c normal, of which 9 cases had just discovered diabetes; 7 cases of Hb A1c false Sex increased. Conclusions Immune turbidimetric assay results of Hb A1c is very unstable and can not accurately reflect the patient’s blood glucose levels 8 weeks ago. Remind clinicians that the results should be used as a guide only to properly assess the treatment of newly-diagnosed and uncontrolled diabetic patients.