浙江大学学报（医学版）
浙江大學學報（醫學版）
절강대학학보（의학판）
JOURNAL OF ZHEJIANG UNIVERSITY MEDICAL SCIENCES
2014年
2期
187-192
,共6页
陈永健%周永列%徐莉%严杰
陳永健%週永列%徐莉%嚴傑
진영건%주영렬%서리%엄걸
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
沉澱素試驗%聚乙烯二醇類/診斷應用%高催乳素血癥/診斷%催乳素%普查
침정소시험%취을희이순류/진단응용%고최유소혈증/진단%최유소%보사
Precipitin tests%Polyethylene glycols/diagnostic use%Hyperprolactinemia/diagnosis%Prolactin%Mass screening
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。
目的：運用聚乙二醇6000沉澱篩檢血清催乳素（ PRL）水平升高患者中巨催乳素血癥併進行臨床樣本驗證。方法：運用聚乙二醇6000沉澱去除PRL升高患者血清中的巨催乳素分子（MPRL）。採用Sephacryl S-100HR層析柱聯閤化學髮光免疫分析法、十二烷基硫痠鈉-聚丙烯酰胺凝膠電泳聯閤蛋白質印跡法檢測聚乙二醇6000沉澱血清MPRL的效果。採用聚乙二醇6000沉澱及化學髮光免疫分析法檢測PRL升高患者血清樣本中的MPRL併篩查巨催乳素血癥。分析真性高催乳素血癥、高催乳素血癥＋巨催乳素血癥、真性巨催乳素血癥患者不同臨床錶現。結果：聚乙二醇6000沉澱後，血清樣本中MPRL峰或MPRL雜交信號明顯降低，但對大分子催乳素（ BPRL）和小分子催乳素（ SPRL）無明顯影響。1538例血清PRL升高患者中，16．1％（247/1538）為巨催乳素血癥，其餘83．9％（1291/1538）為真性高催乳素血癥。247例巨催乳素血癥樣本中，93．5％（231/247）為真性巨催乳素血癥，6．5％（16/247）為巨催乳素血癥＋高催乳素血癥。508例真性高催乳素血癥患者中86．2％（438/508）有月經不調、停經/閉經、不孕不育或垂體瘤疾病，85．7％（6/7）高催乳素血癥＋巨催乳素血癥患者有上述臨床錶現，真性巨催乳素血癥患者僅15．5％（11/71）有上述臨床錶現。結論：血清PRL升高患者中有一定比例的真性巨催乳素血癥（假性高催乳素血癥），運用聚乙二醇6000沉澱檢測能簡便有效地區分真性或假性高催乳素血癥患者。
목적：운용취을이순6000침정사검혈청최유소（ PRL）수평승고환자중거최유소혈증병진행림상양본험증。방법：운용취을이순6000침정거제PRL승고환자혈청중적거최유소분자（MPRL）。채용Sephacryl S-100HR층석주연합화학발광면역분석법、십이완기류산납-취병희선알응효전영연합단백질인적법검측취을이순6000침정혈청MPRL적효과。채용취을이순6000침정급화학발광면역분석법검측PRL승고환자혈청양본중적MPRL병사사거최유소혈증。분석진성고최유소혈증、고최유소혈증＋거최유소혈증、진성거최유소혈증환자불동림상표현。결과：취을이순6000침정후，혈청양본중MPRL봉혹MPRL잡교신호명현강저，단대대분자최유소（ BPRL）화소분자최유소（ SPRL）무명현영향。1538례혈청PRL승고환자중，16．1％（247/1538）위거최유소혈증，기여83．9％（1291/1538）위진성고최유소혈증。247례거최유소혈증양본중，93．5％（231/247）위진성거최유소혈증，6．5％（16/247）위거최유소혈증＋고최유소혈증。508례진성고최유소혈증환자중86．2％（438/508）유월경불조、정경/폐경、불잉불육혹수체류질병，85．7％（6/7）고최유소혈증＋거최유소혈증환자유상술림상표현，진성거최유소혈증환자부15．5％（11/71）유상술림상표현。결론：혈청PRL승고환자중유일정비례적진성거최유소혈증（가성고최유소혈증），운용취을이순6000침정검측능간편유효지구분진성혹가성고최유소혈증환자。
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 .
