巨泌乳素筛查对诊断高泌乳素血症的临床意义  

The clinical significance of macroprolactin screening in the diagnosis of hyperprolactinemia

作　　者：徐佳丽[1] 张丽梅[1] XU Jiali;ZHANG Limei(Endocrine Laboratory of the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院内分泌实验室,哈尔滨150086

出　　处：《国际免疫学杂志》2024年第6期607-610,共4页International Journal of Immunology

基　　金：黑龙江省博士后科研启动基金(21042220105)。

摘　　要：目的探讨巨泌乳素(macroprolactin,M-PRL)筛查对诊断高泌乳素血症(hyperprolactinemia,HPRL)的临床意义。方法在2022年9月1日至2023年8月31日哈尔滨医科大学附属第二医院就诊的女性患者中,选取100例泌乳素(prolactin,PRL)测定值偏高者作为HPRL组,经聚乙二醇(polyethylene glycol,PEG)沉淀后按回收率又分为M-PRL组、混合PRL组、单体PRL(monomeric PRL,mono-PRL)组。100例PRL测定值正常者作为对照组。样本均采用荧光磁微粒酶免法进行检测。结果HPRL组M-PRL检出率为28%,对照组M-PRL检出率为0%,差异具有统计学意义(χ^(2)=32.56,P<0.05)。Mono-PRL组PEG处理前后PRL水平差异无统计学意义:[μIU/mL:(1057.55±592.19)比(1006.24±386.50),t=1.74,P>0.05],M-PRL组PEG处理前后PRL水平差异具有统计学意义:[μIU/mL:(986.66±268.98)比(305.14±88.77),t=15.83,P<0.05],混合PRL组PEG处理前后PRL水平差异具有统计学意义:[μIU/mL:(999.85±242.53)比(494.03±119.84),t=12.78,P<0.05]。结论M-PRL的存在是造成误判为HPRL的常见原因,应用PEG沉淀联合酶免法可筛查M-PRL,准确诊断HPRL,对避免误诊误治具有重要临床意义。Objective To investigate the clinical significance of macroprolactin(M-PRL)screening in the diagnosis of hyperprolactinemia(HPRL).Methods Among the female patients who visited the Second Affiliated Hospital of Harbin Medical University from September 1,2022 to August 31,2023,100 patients with high prolactin(PRL)were selected as the HPRL group.After precipitation by polyethylene glycol(PEG),they were divided into M-PRL group,mixed PRL group and monomeric PRL(mono-PRL)group according to the recovery rate.100 cases with normal PRL values were selected as the control group.The samples were detected by fluorescent magnetic particle enzyme immunoassay.Results The detection rate of M-PRL in the HPRL group was 28%,and the detection rate of M-PRL in the control group was 0%.The difference between the two groups was statistically significant(χ^(2)=32.56,P<0.05).There was no significant difference in PRL level before and after PEG treatment in mono-PRL group:[μIU/mL:(1057.55±592.19)vs(1006.24±386.50),t=15.83,P<0.05].The difference of PRL level before and after PEG treatment in M-PRL group was statistically significant:[μIU/mL:(986.66±268.98)vs(305.14±88.77),t=12.78,P<0.05],and the difference of PRL level before and after PEG treatment in mixed PRL group was statistically significant[μIU/mL:(999.85±242.53)vs(494.03±119.84),t=1.74,P>0.05].Conclusion The presence of M-PRL is a common cause of misjudgment as HPRL.The application of PEG precipitation combined with enzyme immunoassay can screen M-PRL and accurately diagnose HPRL,which has important clinical significance for avoiding misdiagnosis and mistreatment.

关 键 词：聚乙二醇沉淀法 高泌乳素血症 巨泌乳素 

分 类 号：R584[医药卫生—内分泌]