Index Interpretation Test Index Clinical Interpretation (18) Hemoglobin anemia

Anti-alkali hemoglobin

Anti- alkali hemoglobin

(Alkali resistant hemoglobin, HbF)

(Alkali resistant hemoglobin, HbF) (alkali resistant hemoglobin, HbF)

Normal value

Normal value

Colorimetry: Adults: 1%~3.

Newborn: 5.

Influencing factors

Influencing factors

Note during operation: the hemoglobin solution must be fresh, the alkalization time must be accurate, and the colorimetric determination within 1h after filtration

Clinical interpretation

Clinical interpretation

A mild increase in HbF can be seen in: 50% of mild β-globinogenesis anemia, aplastic anemia (AA), paroxysmal nocturnal hemoglobinuria (PNH), polycythemia vera, sideroblast anemia, leukemia

Significant increases are seen in: severe globinogenesis anemia; α, F, A2F and gamma-globinogenesis anemia and HbH disease patients can also increase HbF; delta-globinogenesis anemia HbF does not increase

Hemoglobin electrophoresis

Hemoglobin electrophoresis hemoglobin electrophoresis

(Hemoglobin electrophoresis)

(Hemoglobin electrophoresis) (hemoglobin electrophoresis)

Normal value

Normal value

1.

Normal hemoglobin electrophoresis zone: HbA>95%, HbF<2%, HbA2 is 1%~3.

2.

Mainly used for the detection of HbH and Hb Barts

Influencing factors

Influencing factors

1.

2.

3.

4.

Clinical interpretation

Clinical interpretation

1.

2.

Hemoglobin A2 determination

Hemoglobin A2 determination Hemoglobin A2 determination

Normal value

Normal value

The HbA2 of healthy adults is 1.

Influencing factors

Influencing factors

1.
The specimens used should be fresh
.

2.
Pay attention to adding buffer solution during the whole operation, and do not let the prepared column dry out
.

3.
If there is abnormal protein, the isoelectric point of some abnormal hemoglobin is close to HbA2, pay attention to prevent false positive results
.

Clinical interpretation

Clinical interpretation

1.
The increase in HbA2 is 4%~8%, most of which are mild β-globin synthesis anemia, and some blood diseases, tumors, liver diseases and other HbA2 also have a slight increase
.

2.
Reduction of HbA2 is seen in α-globin and δ-globin synthesis disorders, as well as severe IDA and inherited HbF persistence syndromes
.

Thermal instability test

Thermal instability test Thermal instability test

(Heat instability test)

(Heat instability test) (heat instability test)

Normal value

Normal value

≤5%

Influencing factors

Influencing factors

All instruments must be water-free and dry to avoid hemolysis
.

Clinical interpretation

Clinical interpretation

Positives are mainly seen in PNH.
In addition, the positive rate of HS and autoimmune hemolytic anemia is lower than that of PNH.
This test is used for PNH screening test
.

Fetal Hemoglobin (HbF) Acid Elution Test

Fetal Hemoglobin (HbF) Acid Elution Test Fetal Hemoglobin (HbF) Acid Elution Test

(Fetal hemoglobi acid washing test)

(Fetal hemoglobi acid washing test) (fetal hemoglobi acid washing test)

Normal value

Normal value

All red blood cells in cord blood are positive, with a positive rate of 55% to 85% for newborns, and 67% for infants after 1 month, and occasionally less than 1% for adults after 4 to 6 months
.

Influencing factors

Influencing factors

1.
The pH of the buffer, the temperature and time of acid elution should be strictly controlled to ensure the accuracy of the measurement results
.

2.
The specimen must be fresh or stored in a refrigerator at 4°C for less than 3 days of sodium citrate anticoagulant.
The blood slice needs to be stained within 2 hours, otherwise false positive results may occur
.

3.
If it is difficult to distinguish white blood cells from red blood cells during observation, use hematoxylin staining solution to stain white blood cells first
.

Clinical interpretation

Clinical interpretation

1.
There are increased stained cells in the anemia of globinogenesis disorder.
Most red blood cells are stained red in severe patients, and a few red cells can be seen in mild patients
.

2.
In hereditary persistent fetal hemoglobin syndrome, all red blood cells are stained red
.

Hemoglobin H inclusion body detection

Hemoglobin H inclusion body detection Hemoglobin H inclusion body detection

Normal value

Normal value

0~5% for healthy people
.

Influencing factors

Influencing factors

1.
Atypical inclusion bodies should be distinguished from reticulocytes.
The shape of inclusion bodies is a blue spherical body evenly distributed in the red blood cells, which has refractive properties
.
The net-like substance in the reticulocytes is unevenly arranged in a granular or net-like form
.

2.
Inclusion bodies in red blood cells of HbH disease are generally formed within 10min to 2h.
Observe whether there are more red blood cells containing inclusion bodies than positive cells incubated for 10min after incubation for 2h, so as to know whether there is unstable hemoglobin such as HbH
.

3.
It is advisable to air-dry the film immediately after pushing the film, otherwise the red blood cell morphology is not clear, which will affect the observation
.

4.
It should be counted in time after production
.
Otherwise, the denatured hemoglobin bodies may fade and disappear after being placed for too long
.

Clinical interpretation

Clinical interpretation

1.
Unstable hemoglobinopathy: Inclusion bodies formed by the precipitation of denatured globin peptide chains can appear in most cells after 1 to 3 hours of incubation
.

2.
HbH disease: Inclusion bodies can appear after 1 hour of incubation, also called HbH inclusion bodies
.

3.
G-6-PD deficiency or cell reductase deficiency and chemical substance poisoning, inclusion bodies may also appear in red blood cells
.

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