【摘要】目的研究糖尿病慢性肾脏疾病(CKD)患者的HbA1c检测受氨甲酰化血红蛋白(CHb)干扰的情况。方法收集72例CKD患者的标本，分别使用亲和层析法(Primus Ultra2)、离子交换法(VariantⅡ、HA-8160和G7)及参考(IFCC)方法检测。对正常新鲜血进行体外氨甲酰化实验。采用线性回归分析和Bland-Altman方法进行统计学分析。结果血尿素含量逐渐升高，但HbA1c值未相应增加。血红蛋白体外氨甲酰化前和后的变化为：HA-8160 +0.1%、VariantⅡ+0.4%、G7 -0.3%和Primus Ultra2 0%。HA8160检测值与IFCC方法测定结果最为接近，差值的均值接近0，其他方法测定结果均高于IFCC方法结果。结论4种方法检测HbA1c均不受CHb的干扰。

　　【关键词】糖尿病慢性肾脏病;糖化血红蛋白;氨甲酰化血红蛋白;离子交换法;亲和层析法

　　　【Abstract】Objective To investigate the interference of carbamylated hemoglobin (CHb) to HbA1c test in chronic kidney disease (CKD) of diabetic patients.Methods72cases patients with CKD were collected and tested by means of affinity chromatography (Primus Ultra2), ion exchange chromatography (VariantⅡ, HA-8160 and G7) and reference (IFCC) method. In vitro carbamylation experiments were performed. Linear regression and Bland-Altman analysis were also performed.Results With the increase of urea from CKD 3 to 5, there was no concurrent increase of HbA1c.The difference of after-cabarmylation and before-cabarmylation were +0.1% (HA-8160), +0.4% (VariantⅡ), -0.3% (G7) and 0% (Primus Ultra2). Value of HA-8160 was the closest one to IFCCmethod’s value with difference almost to 0, while the rest ones showed higher values than IFCC method’s value. ConclusionThe HbA1c test is not interfered by the four methods.

　　【Key words】Chronic kidney disease (CKD);Glycosylated hemoglobin;Carbamylatedhemoglobin (CHb); Ion exchange chromatography;Affinity chromatography