巨催乳素血症及检测方法的研究进展

Research progress of macroprolactinemia and detection methods

血清催乳素分子主要有3种不同存在形式,包括单体催乳素(23 kD)、大催乳素(40~60 kD)和与免疫球蛋白G(IgG)结合的巨催乳素分子(150 kD)。巨催乳素分子生物活性低但有免疫活性。巨催乳素血症是高催乳素血症(HPRL)的常见原因之一,常被误诊为催乳素瘤而过度诊疗。血清巨催乳素检测方法包括凝胶过滤层析法、聚乙二醇(polyethylene glycol,PEG)沉淀法和超滤法,除PEG沉淀法在英国常规用于临床检测巨催乳素血症,国内外临床上未广泛开展。本文就高催乳素血症中巨催乳素血症及检测方法相关问题进行综述,以加强临床医生对巨催乳素血症的认识和提高诊疗水平。

There are three main forms of prolactin in serum,including monomeric prolactin(23 kD),bigprolactin(40-60 kD)and macroprolactin(150 kD)combined with immunoglobulin G(IgG).Macroprolactin has immunological activity but low biological activity.Macroprolactinemia is one of the common causes of hyperprolactinemia,which is often misdiagnosed as prolactinoma and overtreated.Serum macroprolactin detection methods mainly include gel filtration chromatography(GFC),polyethylene glycol(PEG)precipitation and ultrafiltration.Except for PEG precipitation that is routinely used in clinical screening in the United Kingdom,macroprolactin detection has not been widely carried out in clinical practice at home and abroad.This review summarizes the issue of macroprolactinemia and its detection in patients with hyperprolactinemia to strengthen clinicians′understanding and achieve accurate diagnosis and treatment.