培训课件_HbAc基础知识培训.ppt

谢谢！ * * * * * So boronate affinity methods are measuring not only HbA1c but hemoglobins glycated at other sites as well. * Hemoglobin Variants and Derivatives: Genetic variants (e.g. HbS trait, HbC trait) and chemically modified derivatives of hemoglobin (e.g. carbamylated Hb in patients with renal failure, acetylated Hb in patients taking large amounts of aspirin) can affect the accuracy of HbA1c measurements.? The effects vary depending on the specific Hb variant or derivative and the specific HbA1c method.? Table 1 contains information for most of the commonly used HbA1c methods for some of the more common Hb variants and derivatives. Interferences from less common Hb variants and derivatives are discussed in Bry, et al (1). ?All entries in Table 1 are based on published information.? In addition, if a product insert indicates clearly that there is inference from a particular factor, then the interference is entered as “yes” and the product insert is cited.?? When selecting an assay method, laboratories should take into consideration characteristics of the patient population served, (e.g. high prevalence of hemoglobinopathies or renal failure). Shortened Erythrocyte Survival: Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss, hemolytic anemia) will falsely lower HbA1c test results regardless of the assay method used (23).? HbA1c results from patients with HbSS, HbCC, and HbSC must be interpreted with caution given the pathological processes, including anemia, increased red cell turnover, transfusion requirements, that adversely impact HbA1c as a marker of long-term glycemic control.? Alternative forms of testing such as glycated serum protein (fructosamine) should be considered for these patients. Other factors: Vitamins C and E are reported to falsely lower test results, possibly by inhibiting glycation of hemoglobin (24, 25); vitamin C may increase values with some assays (25).? Iron-deficie