Hb-F alkali denaturation test
The Hb-F alkali denaturation test measures the absorbance by mixing dissolved blood with a certain amount of NaOH solution, and detects the concentration of HbF. Can reflect diseases such as anemia, porphyria, leukemia. Basic Information Specialist classification: cardiovascular examination classification: blood examination Applicable gender: whether men and women apply fasting: not fasting Tips: Pay attention to rest before the examination, and keep blood on an empty stomach. Normal value Normal adults are less than 2%. It varies with age. Premature infants 81.71 ± 1.94 (70.6 ~ 91.4). Full-term children 69.79 ± 1.47 (45 ~ 89). Newborns 68.39 ± 2.06 (48.4 ~ 92.8). From January to March, 35.74 ± 4.11 (7.49 ~ 81.7). 4 to June 8.08 ± 1.34 (2.43 ~ 39.4). 7 to December 3.39 ± 0.29 (1.37 ~ 7.8). 1 to 3 years old 2.58 ± 0.15 (1.02 ~ 4.73). 4 to 6 years old 1.81 ± 0.12 (0.9 ~ 3.18). 7 to 11 years old 0.81 ± 0.06 (0.4 ~ 1.7). 12 to 16 years old 0.93 ± 0.06 (0.4 ~ 1.5). Clinical significance Abnormal result Increased, newborns greater than 40%, after 2 years of age to adults higher than 2.5%, may suffer from globin-producing anemia. HbF is as high as 100% in persistent fetal hemoglobin. HbF is relatively increased in some diseases, including malignant diseases such as myelofibrosis after radiation therapy, malignant tumor bone marrow metastasis, acute or chronic leukemia, plasmacytoma; non-malignant diseases with aplastic anemia, pure red blood cell aplastic anemia, PNH, not Treatment of pernicious anemia, porphyria and the like. Newborns in need of examination, people with blood diseases. Precautions Inappropriate crowd: None. Taboo before the test: pay attention to rest, keep blood on an empty stomach. Do not wear clothes that are too small or too tight in cuffs to avoid the sleeves being too tight when blood is drawn or the sleeves are too tight after blood draw, causing blood vessels in the arms. Avoid strenuous exercise. Requirements for inspection: It may take a long time and you need to wait patiently for results. Additional checks are required as necessary. Inspection process Vascular blood collection was used for testing. Before venous blood collection, carefully check that the needle is securely installed and that there is air and moisture in the syringe. The needle used should be sharp, smooth, ventilated, and the syringe should not leak. Firstly, the skin was disinfected from the inside to the outside and clockwise from the selected venipuncture with a 30g/L iodine swab. After the iodine was volatilized, the iodized trace was wiped out in the same way with a 75% ethanol swab. Fix the lower end of the venipuncture site with the thumb of the left hand, hold the syringe syringe with the thumb and middle finger of the right hand, and fix the needle lower seat with the index finger, so that the bevel of the needle and the scale of the syringe are upward, and the needle is inclined along the vein to make the needle and the skin obliquely penetrate the skin at an angle of 30°. Then, through the vein wall, enter the venous cavity forward at an angle of 5°. After seeing the blood return, the needle will be probed into the spot to avoid the needle slipping out when the blood is collected; but it is not possible to use a deep puncture to avoid hematoma, and immediately remove the cuff. Needle plug can only be pumped out, can not be pushed in, so as to avoid injecting air into the vein to form a gas plug, causing serious consequences. Remove the syringe needle and slowly inject the blood into the anticoagulation tube along the tube wall to prevent hemolysis and foam. After the venous blood is obtained, the hemoglobin is separated, mixed with a certain amount of NaOH solution, and after 1 minute, the semi-saturated ammonium sulfate is added to stop the alkali denaturation reaction. HbF has strong anti-alkali denaturing effect, no denaturation exists in the supernatant, HbA denatures and precipitates, and the supernatant is taken at 540 nm to measure the absorbance, and the concentration of HbF is detected. Not suitable for the crowd Those without examination indications should not be tested. Adverse reactions and risks 1. Infection: Pay attention to aseptic operation when collecting blood, avoid contamination of water and other parts at the blood collection site to avoid local infection. 2, bleeding: after the blood is given a full compression time, especially coagulopathy, bleeding tendency, to avoid local subcutaneous oozing, bruising and swelling.
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