unstable hemoglobin

Unstable hemoglobin is a type of hemoglobinopathy. There are more than ten kinds of unstable hemoglobin found in China. There are three methods currently used to identify unstable hemoglobin. Basic Information Specialist classification: growth and development examination classification: blood examination Applicable gender: whether men and women apply fasting: fasting Tips: All kinds of fresh vegetables, fruits and fruits are rich in vitamins and have high nutritional value. Normal value Heating method <5%. Isopropyl alcohol method is negative. Erythrocyte denaturing globulin small body method <1%. Clinical significance Elevated (or positive) unstable hemoglobinopathy. Positive results may be diseases: faba bean disease, pediatric glucose-6-phosphate dehydrogenase deficiency, glucose-6-phosphate dehydrogenase deficiency, hereditary spherocytosis considerations (1) Thermal instability test: 1 The Hb to be tested should be prepared fresh. Old Hb can be converted to high-speed rail Hb. A false positive will occur. 2 The holding time should be accurate and the temperature should be constant to avoid false positives. (2) Isopropanol test: 117% isopropyl alcohol solution should not be placed for too long after preparation, otherwise it is prone to false negative. 2 Hemoglobin solution must be fresh. If stored for a long time, methemoglobin appears, which can form a false positive. 3 Reagents should be preheated and the temperature should be strictly controlled to prevent false positives. 4 High HbF and G-6-PD-deficient specimens may also be positive. (3) erythrocyte degeneration globin corpuscle examination: 1 This test can also be done with intravenous anticoagulation. 2 incubation time is related to the properties of unstable hemoglobin. Generally, a clear blue spherical refraction body can appear in 1 to 2 hours, but some unstable hemoglobin needs to be incubated for a longer period of time. A typical denaturing globin body appears. 3 After the film is produced, it should be counted in time. If it is stored for too long, the denatured globin bodies in the red blood cells disappear. If it cannot be counted in time, it can be stored in a desiccator or a 37 °C incubator. After 4 tar tar blue staining, it can not be counterstained with Yihong-Methylene blue staining solution. After counterstaining, the counting result can be reduced. 5 Denatured globin bodies need to be differentiated from reticulocytes. The former inclusion body has a large round shape, uniform, diffuse sedimentation, the entire red blood cell matrix disappears, and it needs to be cultivated for more than 10 minutes to become clear. The reticulocytes showed a reticulated sediment within a few minutes after mixing the blood with the tar blue, and the red blood cell matrix was intact. Inspection process Isopropanol test: (1) Take a small test tube containing 1 ml of 17% isopropanol solution preheated for 5 min in a 37 ° C water bath, immediately add 0.1 ml of hemoglobin solution, mix well, then put in a water bath, and immediately time, at 5, The precipitation was observed at 10, 20, 30, and 40 min, respectively. (2) Judgment of results: (++++) Precipitation occurred in 5 min and large precipitate appeared in 20 min. (+++) There was turbidity in 5 min. Coarse particles appeared at 40 min. (++) There was turbidity at 10 min, and fine particles appeared at 40 min. (+) turbidity appeared at 20 min, and extremely fine particles appeared at 40 min. (-) After 40 minutes of incubation, it was still transparent or slightly turbid without particles. (3) erythrocyte degeneration globin corpuscle examination: 1 Take Huang tar blue reagent 0.5ml in a small test tube, add 3 to 4 drops of fresh blood, mix well, add stopper, and incubate in a 37 ° C incubator. 2 At 10 min, 1 h, and 24 h, one drop was taken to make a thin blood film, which was immediately air-dried and observed under an oil microscope. 3 Count 500 red blood cells under the oil microscope, record the number of red blood cells with blue granular refraction bodies, and find the positive percentage. Not suitable for the crowd No taboos. Adverse reactions and risks 1, subcutaneous hemorrhage: due to pressing time less than 5 minutes or blood draw technology is not enough, etc. can cause subcutaneous bleeding. 2, discomfort: the puncture site may appear pain, swelling, tenderness, subcutaneous ecchymosis visible to the naked eye.