Abnormal 血红蛋白s testing

定义

Hemoglobin is a protein in red blood cells that moves oxygen 和 carbon dioxide between the lungs 和 body tissues.

Hemoglobin derivatives are forms of 血红蛋白 altered by attachment of carbon monoxide or certain drugs. High levels of 血红蛋白 derivatives prevent adequate transport of oxygen 和 carbon dioxide 和 cause illness.

This article discusses the test used to detect 和 measure the amount of 血红蛋白 derivatives in your blood.

选择的名字

Met血红蛋白; Carboxy血红蛋白; Sulf血红蛋白

如何执行测试

The test is done using a small needle to collect a sample of blood from a vein or an artery. The sample may be collected from a vein or artery in the wrist, groin, or arm.

在流血之前, your health care provider may test circulation to the h和 (if the wrist is the site). After the blood is drawn, pressure applied to the puncture site for a few minutes stops the bleeding.

How to Prepare for the Test

No special preparation is needed.

For children, it may help to explain how the test will feel 和 why it is done. This may make the child feel less nervous.

考试的感觉如何

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

为什么要进行测试

• Carboxy血红蛋白 is a 血红蛋白 derivative to which carbon monoxide has attached. High amounts of carboxy血红蛋白 ("carbon monoxide poisoning") prevent the normal movement of oxygen 和 carbon dioxide by the blood. Carbon monoxide is released in the exhaust from cars, 卡车, 小型发动机, 炉灶, 灯笼, 烤架, 壁炉, 气体范围, 和炉. In closed spaces such as homes or garages that are not adequately ventilated, carbon monoxide can build up to dangerous levels.
• Sulf血红蛋白 和 met血红蛋白 are rare 血红蛋白 derivatives to which oxygen cannot attach. They may occur when you take certain medicines such as dapsone, 胃复安, 硝酸盐, 或磺胺类药.

正常的结果

Some levels of 血红蛋白 derivatives may be normal:

• Carboxy血红蛋白 -- less than 1.5% (but may be as high as 9% in smokers)
• Met血红蛋白 -- less than 2%
• Sulf血红蛋白 -- undetectable

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

异常结果意味着什么

High levels of 血红蛋白 derivatives can lead to major health problems.

碳氧血红蛋白:

• 10% to 20% -- symptoms of carbon monoxide poisoning begin to appear
• 30% -- symptoms of carbon monoxide poisoning may be severe
• 50% to 80% -- potentially deadly

高铁血红蛋白:

• 10% to 25% -- 肤色偏蓝 (黄萎病)
• 35% to 40% -- shortness of breath 和 headache
• 超过60%—— 嗜睡 和 昏迷
• Over 70% -- potentially deadly

Sulf血红蛋白:

• Values of greater than 10 grams per deciliter (g/dL) or 6.2 millimoles per liter (mmol/L) cause 肤色偏蓝, but do not usually cause harmful effects.

参考文献

张建平，李建平. Hemoglobin variants associated with hemolytic anemia, 改变氧亲和力, 和高铁血红蛋白症. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles 和 Practice. 8日艾德. Philadelphia, PA: Elsevier; 2023:chap 44.

Marshall WJ, Lapsley M, Day A, Shipman K. Therapeutic drug monitoring 和 chemical aspects of toxicology. In: Marshall WJ, Lapsley M, Day A, Shipman K, eds. 临床化学. 9日艾德. St Louis, MO: Elsevier; 2021:chap 21.

Toffalett JG, Rackley CR. Introduction to blood-gas tests 和 blood-gas physiology. In: Toffalett JG, Rackley CR, eds. Blood Gases 和 Critical Care Testing. 3日艾德. Philadelphia, PA: Elsevier; 2022:chap 1.

Vajpayee N, Graham SS, Bem S. Basic examination of blood 和 bone marrow. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis 和 Management by Laboratory Methods. 24日艾德. Philadelphia, PA: Elsevier; 2022:chap 31.