中青年人群泌乳素检测鉴别巨泌乳素的意义探讨

Significance of macroprolactin identification in prolactin detection in young and middle-aged people

目的分析无症状高泌乳素血症(HPRL)者血液样本中泌乳素(PRL)的类型,讨论巨泌乳素(MPRL)的鉴别以及临床意义。方法收集2019年7-12月送检至黑龙江迪安医学检验所有限公司的10 909例样本,使用罗氏cobas e 601电化学发光免疫分析仪检测PRL,对PRL>47.0 μg/L的样本使用聚乙二醇(PEG)沉淀处理后再次检测,计算回收率,统计并分析检测结果。结果 10 909例样本中,不同年龄组的PRL异常升高者所占比例差异均有统计学意义,其中16~22岁组PRL异常升高者比例最高〔25.27%(253/1 001)〕。男性PRL异常升高者比例明显高于女性〔35.85%(114/318)比19.44%(2 059/10 591)〕,差异有统计学意义(P<0.05)。检测结果在47.0~70.5 μg/L与>70.5 μg/L的PRL检测样本经PEG处理后回收率比较差异无统计学意义(P>0.05)。结论不同年龄组的PRL异常升高者比例不同,MPRL的存在未显示与PRL浓度相关,对于HPRL者应该鉴别MPRL存在的可能性,避免不必要的检查以及错误诊断与不当治疗。

Objective To analyze the classification of prolactin(PRL)in patients with hyperprolactinemia(HPRL),and to discuss the identification of macroprolactin(MPRL)and its clinical significance.Methods The PRL concentration of 10909 blood samples sent to Heilongjiang Dean Medical Laboratory Co.,Ltd.for detection from July to December,2019 was detected with Roche cobas e 601 Electrochemiluminescence Immunoassay.Then the samples with PRL results of>47.0μg/L were precipitated by polyethylene glycol(PEG)and detected again,and the recovery was calculated.The test results were analyzed.Results Among the 10909 samples,the proportion of patients with abnormal increasing of PRL in different age groups had significant differences(all P<0.05),and the patients aged of 16-22 years old had the highest proportion with abnormal increasing of PRL[25.27%(253/1001)].The PRL abnormal increasing proportion of male was significantly higher than that of female[35.85%(114/318)vs.19.44%(2059/10591)],with significant difference(P<0.05).There was no significant difference in the recovery of the samples with PRL results of 47.0-70.5μg/L and>70.5μg/L which were precipitated by PEG and detected again(P>0.05).Conclusions The proportion of PRL abnormal increasing in different age groups had significant difference.The presence of MPRL has not been shown to be related to the concentration of PRL.MPRL should be identified in HPRL patients to avoid unnecessary tests and inappropriate treatment.