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HbA1c不可靠时可改测糖化白蛋白(果糖胺)

2012-06-28 段梦 爱唯医学网

      美国杜克大学的Thomas L. O' Connell博士在美国医师协会(ACP)年会上指出,如果遇到糖化血红蛋白A1c(HbA1c)与血糖监测数据不一致的情况,应当提高警惕。   Connell博士强调,由于任何可影响血红蛋白的因素都会干扰HbA1c检查,因此HbA1c与血糖监测结果不一致的情况实际上相当常见。例如,正在接受血液透析、近期接受了输血、患

      美国杜克大学的Thomas L. O' Connell博士在美国医师协会(ACP)年会上指出,如果遇到糖化血红蛋白A1c(HbA1c)与血糖监测数据不一致的情况,应当提高警惕。

  Connell博士强调,由于任何可影响血红蛋白的因素都会干扰HbA1c检查,因此HbA1c与血糖监测结果不一致的情况实际上相当常见。例如,正在接受血液透析、近期接受了输血、患有贫血或血红蛋白病的患者,HbA1c检测值都可能严重失真。

  “对于刚刚输过血的患者,甚至都不用检测HbA1c。医院里常会出现这种情况:1例刚输过血的患者的指血糖高达300 mg/dl,而HbA1c仅为5.5%。”

  血红蛋白病可导致HbA1c测得值虚假地偏高或偏低。人们已经发现了700多种血红蛋白病或异常血红蛋白变体,其中很多是无症状的。美国最常见的血红蛋白病是镰状细胞特质,影响着大约200万人。

  O' Connell博士称,糖化白蛋白(果糖胺)检测是HbA1c检测的良好替代品。糖化白蛋白检测的对象是血液中的糖化蛋白质而非糖化血红蛋白,因此不会受到血红蛋白病的干扰。如果将指血糖比作患者血糖控制情况的快照,将HbA1c比作反映3个月来代谢控制情况的电影,那么糖化白蛋白就像是一部短片,描绘了既往2~3周内的平均血糖浓度。

  O' Connell博士报告称担任赛诺菲-安万特和Amylin公司的顾问。


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1981704, encodeId=5ac31981e0489, content=<a href='/topic/show?id=53782032272' target=_blank style='color:#2F92EE;'>#不可靠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20322, encryptionId=53782032272, topicName=不可靠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Jan 18 08:02:00 CST 2013, time=2013-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2015876, encodeId=e44d20158e6b5, content=<a href='/topic/show?id=33108494c1' target=_blank style='color:#2F92EE;'>#HbA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8494, encryptionId=33108494c1, topicName=HbA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sun Sep 09 08:02:00 CST 2012, time=2012-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304569, encodeId=2619130456910, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sat Jun 30 05:02:00 CST 2012, time=2012-06-30, status=1, ipAttribution=)]
    2013-01-18 许安
  2. [GetPortalCommentsPageByObjectIdResponse(id=1981704, encodeId=5ac31981e0489, content=<a href='/topic/show?id=53782032272' target=_blank style='color:#2F92EE;'>#不可靠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20322, encryptionId=53782032272, topicName=不可靠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Jan 18 08:02:00 CST 2013, time=2013-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2015876, encodeId=e44d20158e6b5, content=<a href='/topic/show?id=33108494c1' target=_blank style='color:#2F92EE;'>#HbA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8494, encryptionId=33108494c1, topicName=HbA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sun Sep 09 08:02:00 CST 2012, time=2012-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304569, encodeId=2619130456910, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sat Jun 30 05:02:00 CST 2012, time=2012-06-30, status=1, ipAttribution=)]
    2012-09-09 Smile2680
  3. [GetPortalCommentsPageByObjectIdResponse(id=1981704, encodeId=5ac31981e0489, content=<a href='/topic/show?id=53782032272' target=_blank style='color:#2F92EE;'>#不可靠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20322, encryptionId=53782032272, topicName=不可靠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Jan 18 08:02:00 CST 2013, time=2013-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2015876, encodeId=e44d20158e6b5, content=<a href='/topic/show?id=33108494c1' target=_blank style='color:#2F92EE;'>#HbA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8494, encryptionId=33108494c1, topicName=HbA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sun Sep 09 08:02:00 CST 2012, time=2012-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304569, encodeId=2619130456910, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Sat Jun 30 05:02:00 CST 2012, time=2012-06-30, status=1, ipAttribution=)]
    2012-06-30 珙桐
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