绝经期女性β-hCG持续低水平升高1例及文献复习  

β-hCG Sustained Low-Level Elevation in Postmenopausal Women:a Case Report and Literature Review

作　　者：朱旭 侯立安[1] 张颖[1] 刘荔[1] 刘欣[1] 苏玉君[1] 王健[1] 夏良裕[1] ZHU Xu;HOU Li’an;ZHANG Ying;LIU Li;LIU Xin;SU Yujun;WANG Jian;XIA Liangyu(Department of Clinical Laboratory,Peking Union Medical College Hospital,Peking Union Medical College&Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院检验科,北京100730

出　　处：《标记免疫分析与临床》2022年第9期1460-1464,共5页Labeled Immunoassays and Clinical Medicine

基　　金：北京市临床重点专科医学检验科卓越项目(编号:ZK201000)。

摘　　要：目的分析1例绝经期女性血人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)持续低水平升高的临床特点及β-hCG干扰实验处理,为临床鉴别诊断提供参考依据。方法回顾性分析2022年1月于北京协和医院就诊的1例绝经期β-hCG持续低水平升高女性的临床资料和实验室检查。分别采用Siemens Atellica IM1600、Roche Cobas e801、Abbott ARCHTECT i2000SR和Beckman UniCel DxI8004个检测平台以及聚乙二醇(polyethylene glycol,PEG)沉淀法对病例血清样本进行处理并重复检测β-hCG,以排除异嗜性抗体及其他可疑干扰。以“人绒毛膜促性腺激素”、“绝经期女性”、“β-hCG持续低水平升高”、“β-hCG参考区间”、“human chorionic gonadotrophin”、“postmenopausal women”、“β-hCG sustained low-level elevation”和“β-hCG reference interval”为关键词在中国知网、万方数据库、PubMed和Web of Science检索自建库至2022年6月报道的绝经期女性β-hCG持续低水平升高的病例报道及相关文献资料,并对检索结果进行总结分析。结果血清样本在Siemens Atellica IM1600、Roche Cobas e801、Abbott ARCHTECT i2000SR和Beckman UniCel DxI8004个平台的检测结果分别为9.00IU/L、7.21IU/L、10.24IU/L和8.63IU/L。样本经PEG沉淀处理后在Siemens Atellica IM1600平台检测,结果为9.10IU/L,回收率为101%,排除异嗜性抗体干扰。检索数据库最终纳入分析的外文文献有18篇,包括1例无症状绝经期女性血β-hCG持续低水平升高的病例报道,以及探讨绝经期女性血β-hCG持续低水平升高的原因、血β-hCG的来源、绝经期女性β-hCG的参考区间和不同实验室定量β-hCG报告差异的研究等。垂体hCG来源是绝经期女性无症状β-hCG低水平升高的主要原因。结论绝经期女性β-hCG可呈生理性升高,实验室应评估干扰因素、参考区间适用性等因素并采取相应措施,为临床合理诊疗提供依据。Objective To analyze clinical characteristics of a case of persistently low elevated bloodβ-human chorionic gonadotropin(β-hCG)in a postmenopausal woman and the treatment response ofβ-hCG interference,so as to provide a reference basis for the clinical differential diagnosis.Methods A retrospective analysis of clinical data and laboratory tests of one case of a woman with persistently low level of elevatedβ-hCG at menopause who attended Peking Union Medical College Hospital in January 2022 was conducted.Four testing platforms,including Siemens Atellica IM1600,Roche Cobas e801,Abbott ARCHTECT i2000SR and Beckman UniCel DxI800,and polyethylene glycol(PEG)precipitation method were used for the serum samples of the case,respectively.Serum samples were processed and repeated forβ-hCG to exclude heterophilic antibodies and other suspicious interferences.With“human chorionic gonadotrophin”,“postmenopausal women”,“β-hCG sustained low-level elevation”,“β-hCG reference interval”as keywords,we searched related studiess in CNKI,Wanfang databases,PubMed and Web of Science.The case reports and related literature ofβ-hCG sustained low-level elevation in postmenopausal women were searched from these databases up to June 2022,and the search results were summarized and analyzed.Results The results of the serum samples were 9.00 IU/L,7.21 IU/L,10.24 IU/L,and 8.63 IU/L on four platforms:Siemens Atellica IM1600,Roche Cobas e801,Abbott ARCHTECT i2000SR,and Beckman UniCel DxI800,respectively.The sample was treated by PEG precipitation and tested on the Siemens Atellica IM1600 platform with a recovery of 9.10 IU/L and 101%,excluding heterophilic antibody interference.The search scope was eventually included in the analysis with 18 foreign literature,including a case report of an asymptomatic postmenopausal woman with persistently low elevated bloodβ-hCG,and studies exploring the causes of persistently low elevated bloodβ-hCG in postmenopausal women,the source of bloodβ-hCG,the reference interval ofβ-hCG in po

关 键 词：人绒毛膜促性腺激素 绝经期女性 β-hCG持续低水平升高 垂体hCG 参考区间 

分 类 号：Q591.1[生物学—生物化学]