运用聚乙二醇6000沉淀筛检巨催乳素血症患者  

Screening and detection of patients with macroprolactinemia by application of polyethylene glycol precipitation method

作　　者：陈永健[1,2] 周永列[2] 徐莉[2] 严杰[1] 

机构地区：[1]浙江大学医学院基础医学部,浙江杭州310058 [2]浙江省人民医院检验医学中心,浙江杭州310058

出　　处：《浙江大学学报（医学版）》2014年第2期187-192,共6页Journal of Zhejiang University(Medical Sciences)

摘　　要：目的：运用聚乙二醇6000沉淀筛检血清催乳素（ PRL）水平升高患者中巨催乳素血症并进行临床样本验证。方法：运用聚乙二醇6000沉淀去除PRL升高患者血清中的巨催乳素分子（MPRL）。采用Sephacryl S-100HR层析柱联合化学发光免疫分析法、十二烷基硫酸钠-聚丙烯酰胺凝胶电泳联合蛋白质印迹法检测聚乙二醇6000沉淀血清MPRL的效果。采用聚乙二醇6000沉淀及化学发光免疫分析法检测PRL升高患者血清样本中的MPRL并筛查巨催乳素血症。分析真性高催乳素血症、高催乳素血症＋巨催乳素血症、真性巨催乳素血症患者不同临床表现。结果：聚乙二醇6000沉淀后，血清样本中MPRL峰或MPRL杂交信号明显降低，但对大分子催乳素（ BPRL）和小分子催乳素（ SPRL）无明显影响。1538例血清PRL升高患者中，16．1％（247/1538）为巨催乳素血症，其余83．9％（1291/1538）为真性高催乳素血症。247例巨催乳素血症样本中，93．5％（231/247）为真性巨催乳素血症，6．5％（16/247）为巨催乳素血症＋高催乳素血症。508例真性高催乳素血症患者中86．2％（438/508）有月经不调、停经/闭经、不孕不育或垂体瘤疾病，85．7％（6/7）高催乳素血症＋巨催乳素血症患者有上述临床表现，真性巨催乳素血症患者仅15．5％（11/71）有上述临床表现。结论：血清PRL升高患者中有一定比例的真性巨催乳素血症（假性高催乳素血症），运用聚乙二醇6000沉淀检测能简便有效地区分真性或假性高催乳素血症患者。Objective：To establish a polyethylene glycol （ PEG6000 ） precipitation method for screening macroprolactinemia in patients with high serum prolactin （ PRL） . Methods：PEG6000 precipitation method was used to remove macroprolactin （ MPRL） molecules in serum of PRL-elevated patients.The effect of PEG6000 precipitating serum MPRL was determined by Sephacryl S-100 HR chromatography plus chemiluminescent immunoassay and SDS-PAGE plus Western Blot assay .The PEG6000 precipitation plus chemiluminescent immunoassay was applied to screen serum samples of PRL-elevated patients for macroprolactinemia .The clinical manifestations of patients with true-hyperprolactinemia , hyperprolactinemia/macroprolactinemia or true-macroprolactinemia were analyzed and compared .Results： After precipitation with PEG6000 , MPRL peak or hybridization signal in the serum samples was markedly decreased, while the big or small prolactin （BPRL or SPRL） levels were not affected. In 1538 PRL-elevated patients , 16 .1% （ 247/1538 ） were detectable for macroprolactinemia , while the 83 .9% （ 1291/1538 ） were identified as true-hyperprolactinemia .In 247 samples of macroprolactinemia , 93 .5% （ 231/247 ） were determined as true-macroprolactinemia, while 6.5% （ 16/247 ） were identified as hyperprolactinemia plus macroprolactinemia .In 508 true-hyperprolactinemia patients , menoxenia , menolipsis/menostasia , dysgenesia or hypophysoma were manifested in 438 （86.2%）, which were also manifested in 85.7% （ 6/7 ） of hyperprolactinemia/macroprolactinemia patients .However , only 11 cases in 71 true-macroprolactinemia patients （ 15 .5%） presented above clinical diseases .Conclusion： There is a certain proportion of true-macroprolactinemia （ pseudo-hyperprolactinemia ） in serum PRL-elevated patients.The PEG6000 precipitation method established in this study can efficiently distinguish true-hyperprolactinemia from pseudo-hyperprolactinemia in patients .

关 键 词：沉淀素试验 聚乙烯二醇类 诊断应用 高催乳素血症 诊断 催乳素 普查 

分 类 号：R446.1[医药卫生—诊断学]