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糖化血红蛋白的检测水平受红细胞寿命、血红蛋白变异体、血液系统疾病和检测方法学差异等多种因素的影响，不同检测技术对干扰因素的敏感性不同。本文围绕糖化血红蛋白检测技术的临床应用，系统论述糖化血红蛋白的生物形成机制和影响因素，分析离子交换高效液相色谱法、免疫法、酶法、毛细管电泳法、亲和层析法5种主流检测技术的原理特性，精密度和准确度差异，并针对血红蛋白变异体干扰、血液系统疾病、终末期肾病等特殊临床状态下的方法适用性展开探讨。本文提出的在血红蛋白病高发地区和特殊人群中应建立方法学联合检测的观点，建议临床实验室应根据患者人群特征、疾病谱分布和实验室条件综合选择检测方法。强调对已知或疑似血红蛋白病的患者应结合图谱分析、替代指标检测和多方法学对比方式确保结果准确性，旨在为临床实验室科学选择糖化血红蛋白检测方法、正确解读特殊状态下的检测结果提供理论参考和实践指导，对提升糖尿病诊疗的精准性、避免误诊具有一定临床意义，为推动基层医疗机构检测标准化和技术普及提供参考。

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