血清17羟孕酮升高的临床鉴别诊断思路  

Clinical interpretation of elevated serum 17 hydroxyprogesterone levels

作　　者：曾少豪 单双红 何君瑜 张路遥[1] 李延兵[1] 廖志红[1] Zeng Shaohao;Shan Shuanghong;He Junyu;Zhang Luyao;Li Yanbing;Liao Zhihong(Department of Endocrinology,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000)

机构地区：[1]中山大学附属第一医院内分泌内科,广州510000

出　　处：《国际内分泌代谢杂志》2023年第6期485-488,共4页International Journal of Endocrinology and Metabolism

基　　金：中山大学附属第一医院临床专科能力建设支持计划。

摘　　要：本文综述液相色谱-串联质谱法与免疫分析法检测血清17α-羟孕酮(17OHP)的对比和联系,影响血清17OHP的因素,以及血清17OHP升高的原因分析。引起17OHP升高的疾病包括先天性肾上腺皮质增生症(CAH)、肾上腺肿瘤、卵巢肿瘤、糖尿病等。本文汇总了会引起17OHP升高的CAH亚型、各亚型特征性的类固醇激素变化组合谱,尤其是21羟化酶缺乏症的诊治进展。女性需在卵泡期测量17OHP,最好采用质谱法检测,在区别CAH的原因和治疗评估中,选择类固醇代谢通路中多项激素的不同组合的检测更有意义。This article reviews the measurement methods for serum 17α-hydroxyprogesterone(17OHP),compares its immunoassay with liquid chromatography tandem mass spectrometry measurements,and the factors that affect serum 17OHP levels.Diseases that can cause elevated 17OHP levels include congenital adrenal hyperplasia(CAH),adrenal tumors,ovarian tumors,diabetes,and others.We summarize the clinical characteristics and chemical spectra of the adrenal steroid biosynthesis pathway for CAH subtypes with increased 17OHP,focusing on 21-hydroxylase deficiency.For females,it is recommended to measure 17OHP using mass spectrometry during the early follicular phase.To identify CAH subtypes and evaluate the ideal treatment dosage of steroids,it is more meaningful to investigate the optimal adrenal steroid spectrum panels in the future.

关 键 词：17α-羟孕酮 液相色谱-串联质谱法 类固醇激素组合谱 先天性肾上腺皮质增生症 肾上腺肿瘤 

分 类 号：R736.6[医药卫生—肿瘤]