超高压液相色谱-质谱联用技术联合分析血清睾酮和硫酸脱氢表雄酮提高多囊卵巢综合征的诊断率  

Improve diagnostic performance of PCOS by measurements of testosterone and dehydcoepiandrosterone sulfate with ultra-performance liquid chromatography tandem mass spectrometry

作　　者：夏曦[1] 邓玉颖 顾俊婕 顾燕云[2] 张翼飞[2] 童雪梅[1] 周文中[2] 

机构地区：[1]上海交通大学基础医学院生物化学与分子细胞生物学系,上海市肿瘤微环境与炎症重点实验室,200025 [2]上海交通大学医学院附属瑞金医院内分泌代谢病科,上海市内分泌代谢病研究所,上海市内分泌代谢病临床医学中心

出　　处：《中华内分泌代谢杂志》2018年第2期136-140,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的比较超高压液相色谱-质谱联用技术（UPLC-MS/MS）和化学发光免疫学技术（CLIA）测定雄性激素水平高低与多囊卵巢综合征（PCOS）的临床诊断符合率。 方法采用UPLC-MS/MS和CLIA分别测定160例PCOS患者和146名正常对照者血清中的雄性激素——睾酮（T）和硫酸脱氢表雄酮（DHEA-S）水平，并结合体重指数（BMI）等参数绘制ROC曲线，计算曲线下面积（AUC），选择与临床特征最符合的测定方法为多囊卵巢综合征临床诊断服务。 结果（1）两种方法测定的T的AUC无统计学差异（P＝0.17）。UPLC-MS/MS测定的DHEA-S的AUC明显优于CLIA法（P〈0.01）。（2）UPLC-MS/MS测定T联合DHEA-S的AUC明显优于CLIA法（P〈0.01），也优于其单独测定T（P〈0.01）或DHEA-S的AUC（P〈0.01）。（3）UPLC-MS/MS法测定的T、DHEA-S联合BMI的AUC明显优于CLIA法（P〈0.01），也优于其两指标联合测定的AUC（P〈0.05）。 结论UPLC-MS/MS检测法测定的雄性激素水平联合被测者的BMI对PCOS有更高的检出率，并具有一定的临床应用和推广价值。Objective To compare ultra-performance liquid chromatography tandem mass spectrometry （UPLC-MS/MS） and chemiluminescence immunoassay （CLIA） measurement of human serum androgen levels in polycystic ovarian syndrome（PCOS）. Methods 160 PCOS patients and 146 healthy subjects （ control group） were recruited and their serum androgen levels measurements of testosterone and dehydcoepiandrosterone sulfate （DHEA-S） were tested by UPLC-MS/MS and CLIA. The androgen results combined with body mass index（BMI） were analyzed by ROC curve. According to area under curve （AUC） calculated by SPSS, a better method will be selected to provide accurate test results for physicians. Results （ 1 ） AUC of DHEA-S tested by UPLC-MS/MS was significantly higher than the one tested by CLIA（ P〈0.01 ）. There was no significant difference between the AUC ofT tested by UPLC-MS/MS and the one tested by CLIA. （2） AUC of T combined with DHEA-S tested by HPLC was not only significantly higher than the AUC of two combined indicators tested by CLIA （ P〈0.01 ） , but also significantly higher than the AUC of a single indicator either T （ P 〈 0.01 ） or DHEA-S （ P 〈 0.01 ） tested by UPLC-MS/ MS. （3）The AUC of T, DHEA-S combined with BMI tested by HPLC was not only significantly higher than the AUC of three combined indicators tested by CLIA （P〈0.01） , but also higher than the AUC of two combined indicators tested by UPLC-MS/MS （P〈0.05）. Conclusion T and DHEA-S tested by UPLC-MS/MS combined with BMI has a certain reference value in the diagnosis of PCOS.

关 键 词：多囊卵巢综合征 超高压液相色谱一质谱联用技术 化学发光免疫学技术 睾酮 硫酸脱氢表雄酮 曲线下面积 

分 类 号：R711.75[医药卫生—妇产科学]