VAI TRÒ CỦA ĐIỆN DI HUYẾT SẮC TỐ

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(còn gọi là Điện di Hemoglobin)?

  Điện di là hiện tượng dịch chuyển của các vật thể mang điện tích dưới tác động của điện trường. Sự dịch chuyển này do thành phần lực điện và trọng lực Lorentz (là lực tổng hợp của lực điện và lực từ tác dụng lên một điện tích điểm nằm trong trường điện từ).

1. Điện di Huyết sắc tố là gì?

– Điện di hemoglobin là một xét nghiệm được thực hiện để kiểm tra các biến thể của hemoglobin trong máu.

– Huyết sắc tố, còn gọi là Hemoglobin là một chất nằm trong tế bào hồng cầu có nhiệm vụ vận chuyển oxy từ phổi đến khắp cơ thể. Xét nghiệm điện di hemoglobin là một xét nghiệm máu, được thực hiện để tìm xem trong máu có sự hiện diện của những loại hemoglobin bất thường hay không và nồng độ của chúng là bao nhiêu.

– Mỗi loại biến thể của Hb có điện tích, kích thước, hình dạng và trọng lượng phân tử khác nhau vì vậy khi sử dụng dòng điện để di chuyển, chúng sẽ di chuyển với tốc độ khác nhau trên giấy Cellulose acetate. Dựa vào đặc tính đó có thể tách các biến thể của Hb trong máu.

ddqsacto

Sự khác biệt về hình thái hồng cầu

2. Các giai đoạn tổng hợp của Hemoglobin:

Quá trình tổng hợp globin bắt đầu từ tuần thứ 2-3 phôi thai, chia làm 3 giai đoạn sau:

* Giai đoạn phôi: Haemoglobin Gower I (x2e2), Haemoglobin Portland (x2g2), Haemoglobin Gower II (a2e2).

* Giai đoạn thai: HbF (a2g2), HbA (a2b2), gần sinh-HbA2 (a2d2).

* Giai đoạn sau sinh: HbA (a2b2), HbA2 (a2d2), HbF (a2g2).

Các huyết sắc tố bình thường là HbA, HbA2, HbF. Cho tới nay người ta phát hiện được ngày càng nhiều loại huyết sắc tố bất thường (>700 loại) như: HbH, HbBarts, HbE, HbS, HbC, HbD, HbI,…

3. Giá trị bình thường của điện di huyết sắc tố:

sacto

4. Điện di huyết sắc tố được chỉ định trong những trường hợp nào?

– Đánh giá những trường hợp thiếu máu tán huyết không giải thích được.

– Thiếu máu hồng cầu nhỏ không liên quan đến giảm sắt, bệnh lý mạn tính, hoặc ngộ độc chì.

– Tiền sử gia đình có bệnh lý hemoglobin.

– Kết quả sàng lọc trước sinh dương tính như xét nghiệm triple test, double test, siêu âm,…

5. Ứng dụng của xét nghiệm điện di Hemoglobin:

5.1. Chẩn đoán bệnh lý huyết sắc tố:

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Bảng 1: Sơ đồ chẩn đoán bệnh lý huyết sắc tố

5.2. Chẩn đoán bệnh thalassemia:

* Bệnh α-Thalassemia:

sacto1

Bảng 2: Đặc điểm bệnh a thalassemia

* Bệnh β-Thalassemia:

sacto2

Bảng 3: Đặc điểm bệnh b thalassemia

6. Phòng bệnh:

  6.1. Đối với trường hợp chưa bị bệnh: gồm thiếu máu tán huyết không giải thích được, thiếu máu hồng cầu nhỏ không liên quan đến giảm sắt, bệnh lý mạn tính hoặc ngộ độc chì, tiền sử gia đình có bệnh lý hemoglobin,… cần được làm xét nghiệm tiếp như công thức máu, điện di hoặc xét nghiệm đột biến gen để xác định bệnh.

  6.2. Đối với trường hợp đã bị bệnh:

  - Sàng lọc những người thân liên quan

  - Sàng sàng trước sinh nếu muốn sinh con.

** Mẫu bệnh phẩm là mẫu máu toàn phần chống đông bằng EDTA

** Việc phát hiện chính xác các loại huyết sắc tố bất thường nên góp phần không nhỏ cho công tác chẩn đoán, điều trị và phòng bệnh.

CN. Tôn Hoàng Dũng

Nguồn:

THALASSEMIA VÀ BỆNH HEMOGLOBIN (TS BS Nguyễn Minh Tuấn)

http://bvdkquangnam.vn (BVĐK Tỉnh Quảng Nam)

http://benhviennhitrunguong.org.vn (BV Nhi Trung Ương)

https://medlatec.vn (BVĐK Medlactec)

http://tudu.com.vn (BV Từ Dũ)

https://hellobacsi.com (Tham vấn y khoa: TS. Dược khoa Trương Anh Thư.)

https://vicare.vn

Số lượt xem: 176
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