Clinical significance of hemoglobin value (hemoglobin, HB,HGB)

clinical significance of hemoglobin:
The clinical significance of the increase and decrease of hemoglobin is similar to the clinical significance of RBC count, but hemoglobin can better reflect the degree of anemia.

The increase in hemoglobin has the following conditions:

(1) Increase in the number of physiological: In the Highland residents, fetuses and newborns, strenuous activities, fear, cold water bath, etc.

(2) Increased pathology: seen in severe congenital and acquired heart and lung diseases and vascular malformations, such as tetralogy of Fallot, cyanosis congenital heart disease, obstructive emphysema, pulmonary heart disease, pulmonary or pulmonary vein fistula and low oxygen carrying capacity of abnormal hemoglobin disease, etc., also seen in certain tumors or kidney diseases, such as kidney cancer, hepatocellular carcinoma, Kidney embryo tumor and hydronephrosis, polycystic kidney and so on.

The decrease in hemoglobin is seen in the following cases:

(1) Physiological reduction: 3 months of infants to 15 years of age, mainly due to rapid growth and development of the hematopoietic system of the relative insufficiency of hematopoietic, generally can be compared to the normal low of 10%-20%. The mid-and late-pregnancy was diluted due to increased blood volume in pregnancy. In the elderly, the hematopoietic function of bone marrow decreases gradually, which can lead to the decrease of erythrocyte and hemoglobin content.

(2) Decrease in pathological rationality:

A. Bone marrow hematopoietic function failure, such as aplastic anemia, bone marrow fibrosis accompanied by anemia;

B. Anemia due to lack or use of hematopoietic substances, such as iron deficiency anemia, folic acid and vitamin B12 deficiency caused by cytomegalovirus anemia;

C. Anemia caused by excessive red blood cell damage due to erythrocyte membrane, enzyme hereditary defects or exogenous factors, such as hereditary globular RBC syndrome, marine anemia, paroxysmal sleep hemoglobin urine, abnormal hemoglobin disease, hemolytic anemia, Hemolytic anemia caused by major surgery or certain biological and chemical factors in the extracorporeal circulation of the heart, and anemia caused by certain acute or chronic blood loss.

"Reference range"
Male: 120~160G/L (instrument method).
Female: 110~150G/L (instrument method).
Newborn: 165~195g/l (instrument method).
"Impact factor"
1. A large number of smoking, blood hbco (carbon and oxygen hemoglobin) increased, patients HGB will be significantly increased.
2. Hyperlipidemia can make hgb false increase.
3. Vigorous and long-term physical exercise can be reduced.
4. Intravenous input of amino acids affects the accuracy of HB assay, resulting in false increases in HB.
5. Drug impact: Common causes of anemia are: phenytoin sodium, oral contraceptives, estrogen, acetophenone, vitamin K (only K3 and K4), ammonia, chloroquine, quinine, aspirin (bone marrow inhibition and gastrointestinal hemorrhage), non-butyl, chlorobenzene, benzene, sulfonamide, antibiotics, cancer ning, aniline, Antimony compounds, nitrite, lead, benzene, fluoride, allyl amine, carbon disulfide, indomethacin, corticosteroids, rifampicin, furosemide, copper can cause anemia.
"Clinical Significance"
The significance of increasing or decreasing hemoglobin is similar to that of RBC, but it can better reflect the degree of anemia. In various types of anemia, the decrease in hemoglobin volume and the decrease of erythrocyte number are not necessarily parallel. In the case of small erythrocyte anemia (such as iron deficiency anemia), the decrease of hemoglobin is significantly lower than that of red blood cell, while the decrease of erythrocyte number decreases significantly compared with the decrease of hemoglobin in the case of large erythrocyte anemia (such as cytomegalovirus anemia).
1. Elevated in the true red blood cell syndrome, blood oxygen-reduced erythropoietin (including: chronic bronchial, pulmonary disease, cardiac insufficiency and familial erythropoietin), tumor erythropoietin, reactive red blood cell syndrome (including glomerulonephritis and high-speed hemoglobin) and dehydration.
2. The combination of RBC, MCV (Mean red blood cell volume), MCH (average RBC hemoglobin content), MCHC (average RBC haemoglobin concentration), RDW (red blood cell volume distribution width) and other indicators can be used to determine the type of anemia in general.
(1) Normal cell positive pigment anemia: ① cancer, leukemia, aplastic anemia, ② red blood cells cause hemolysis, such as red blood cell enzyme defects, membrane abnormalities, abnormal hemoglobin disease, protein-induced anemia (thalassemia); ③ red blood cells cause hemolysis, such as parasitic disease, poisoning and hemolysis caused by the role of immunization ; ④ acute hemorrhage; ⑤ hypersplenism.
(2) Small cell low pigment anemia: ① iron deficiency, iron and juvenile erythrocyte anemia, ② chronic hemorrhagic anemia, such as ulcerative disease, Menorrhagia, ③ carbon monoxide poisoning, ④ vitamin B6 deficiency.
(3) Large cell high pigment anemia: ① malignant anemia; ② parasitic disease.
(4) Simple small cell anemia: infection, poisoning, chronic inflammation, uremia and so on.

Hemoglobin is the main ingredient of red blood cells. Each hemoglobin molecule consists of 4 heme lignin and a bead protein, each heme comprising 4 pyrrole rings and an iron atom in the center of the ring. The iron in hemoglobin in the second valence state, can be reversible with oxygen (oxygen hemoglobin), if the iron oxide to three-valence state. Hemoglobin is transformed into high-iron hemoglobin, which loses its capacity to carry oxygen. There are four methods for determination of hemoglobin content using ① colorimetric method. This is the most widely used method of clinical use, it can be divided into visual colorimetric and photoelectric colorimetric two types, the latter according to the use of different diluent, then divided into the cyanide high-iron hemoglobin method, alkaline hemoglobin method, acidification hemoglobin and oxygen-hemoglobin method. A good diluent must enable all hemoglobin in the blood to be transformed into a stable hemoglobin derivative, so that the total amount of hemoglobin in the blood can be measured. The cyanide-high-iron hemoglobin method basically has this advantage, it can make in addition to the sulfide hemoglobin (normal blood of very few) all hemoglobin has become a stable cyanide highly heme red protein. So the results measured with this method are accurate and reproducible. Therefore, the cyanide-high-iron hemoglobin method has become the international standard method for the determination of hemoglobin. Hemoglobin visual Colorimetric method accuracy is poor, foreign has been eliminated. However, the method is simple and economical, and it is still used in some primary medical units. ② Test Tiefa. ③ oxygen measurement method. These two methods are complex and not suitable for general use. ④ specific Gravity method. The method is of poor accuracy.

Basic information

Specialty Classification: Growth and Development check classification: blood test

Applicability: Male and female are suitable for fasting: Fasting

Reference Price: 10-30 yuan

Analysis results:

Warm tip: Before checking, pay attention to rest, forbidden diet. Normal

Male 120~160g/l.

Female 110~150g/l.

Newborn 170~200g/l.

Children 110~160g/l.

Clinical significance

1, physiological increase of newborns, plateau residence and so on.

2, pathological increase of true red blood cell syndrome, compensatory red blood cell syndrome.

3, reduce all kinds of anemia, leukemia, postpartum, blood loss and so on.

Results of low-risk diseases: aplastic anemia, iron-based anemia, chronic anemia, high risk of disease: secondary RBC syndrome considerations

HICN is currently the most accurate method of hemoglobin determination, in addition to HBS, HBC and other hemoglobin can be converted into HICN, the introduction of reagents for the International Committee for Hematology Standardization (ICSH) recommended. Since the HICN absorbance coefficient is internationally recognized, it can be calculated directly by the highly calibrated high-level spectrophotometer based on the absorbance coefficient, which is not a routine method of the inspection section.

Indicates a 540nm absorbance, 251 is the blood dilution, 11.0 HB molecule monomer molar absorbance coefficient, 1.0 is the optical diameter, 16114.5 is the monomer molecular weight, except 1000 is converted from mg (mg) to grams (g).

The diluent should be stored in a brown glass bottle, not stored in the plastic bottle, otherwise the cyanide ions adsorbed on the plastic bottle wall, so that the results are low.

Dilute liquid containing potassium cyanide, do not use mouth aspiration liquid. After the determination of waste liquid should be added to dilute the same amount of water, and according to each liter plus sodium hypochlorite solution 35ml, mixed, open the container, placed overnight back into the sewer.

There are many methods of hemoglobin determination, the present methods are not established their own standards, the use of such methods must be cautious, the HICN method should be used as a reference method. In particular, it is important to note that the current sale of hemoglobin-controlled liquid is HICN-controlled, and is used for other methods to be significantly biased.

Inspection process

Take blood 20μl, add diluent 5ml, mix evenly, static 5min after using Spectrophotometer or colorimeter determination, at 540nm wavelength, or green filter, water correction absorbance of 0 points, the measurement of absorbance photometric calculation or standard curve, that is the result.

Not suitable for people

Generally no taboo crowd.

Adverse reactions and risks

Risk of infection: if an unclean needle puncture is used, there may be a risk of infection.

Clinical significance of hemoglobin value (hemoglobin, HB,HGB)