巨泌乳素血症患者血清性激素和甲状腺激素水平研究
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摘要
目的探讨巨泌乳素血症(M-PRL)在体内产生和集聚的可能机制。方法选取高泌乳素(HPRL)患者50例、MPRL患者50例和健康人群25例分别作为HPRL组、M-PRL组和对照组,采用化学发光法检测3组血清性激素和甲状腺素水平,对检测结果进行统计分析。结果 M-PRL组、HPRL组血清睾酮、性激素结合球蛋白(SHBG)水平均高于对照组,差异有统计学意义(P<0.05);M-PRL组、HPRL组血清雌二醇水平低于对照组,差异有统计学意义(P<0.05);M-PRL组血清孕酮水平低于对照组,差异有统计学意义(P<0.05);M-PRL组血清睾酮、雌二醇、促黄体生成素(LH)、促卵泡生成素(FSH)、SHBG水平和LH/FSH比值与HPRL组比较,差异无统计学意义(P>0.05)。结论 M-PRL血症患者体内可能存在一定程度的性腺激素水平异常和自身免疫状态异常。
Objective To study the possible mechanism of in vivo production and congregation of macroprolactinemia(M-PRL).Methods 50 cases of hyperprolactinemia(HPRL),50 cases of M-PRL and 25 healthy persons were selected as the HPRL group,M-PRL group and control group respectively.The chemiluminescence method was adopted to detect the levels of serum hormones and thyroid hormones.Then the detection results were statistically analyzed.Results The levels of serum testosterone,sex hormone binding globulin(SHBG),thyroglobulin antibody and thyroid peroxidase in the M-PRL and HPRL groups were significantly higher than those in the control group.Serum estradiol levels in the M-PRL and HPRL group were lower than those in control group,the difference was statistically significant(P<0.05).Serum Prog level of the M-PRL group was lower than that of the control group,the difference was statistically significant(P<0.05).However the levels of serum testosterone,estradiol,luteinizing hormone(LH),follicle-stimulating hormone(FSH)and SHBG,and LH/FSH ratio had no statistical difference between the M-PRL group and HPRL group(P>0.05).Conclusion Certain degrees of sex hormones abnormality and autoimmune abnormality may exist in the patients with M-PRL.
Objective To study the possible mechanism of in vivo production and congregation of macroprolactinemia(M-PRL).Methods 50 cases of hyperprolactinemia(HPRL),50 cases of M-PRL and 25 healthy persons were selected as the HPRL group,M-PRL group and control group respectively.The chemiluminescence method was adopted to detect the levels of serum hormones and thyroid hormones.Then the detection results were statistically analyzed.Results The levels of serum testosterone,sex hormone binding globulin(SHBG),thyroglobulin antibody and thyroid peroxidase in the M-PRL and HPRL groups were significantly higher than those in the control group.Serum estradiol levels in the M-PRL and HPRL group were lower than those in control group,the difference was statistically significant(P<0.05).Serum Prog level of the M-PRL group was lower than that of the control group,the difference was statistically significant(P<0.05).However the levels of serum testosterone,estradiol,luteinizing hormone(LH),follicle-stimulating hormone(FSH)and SHBG,and LH/FSH ratio had no statistical difference between the M-PRL group and HPRL group(P>0.05).Conclusion Certain degrees of sex hormones abnormality and autoimmune abnormality may exist in the patients with M-PRL.
引文
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[5]Park YM,Lee SH,Lee BH,et al.Prolactin and macroprolactin levels in psychiatric patients receiving atypical antipsychotics:apreliminary study[J].Psychiatry Res,2016,239(3):184-189.
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[9]Lu CC,Hsieh CJ.The importance of measuring macroprolactin in the differential diagnosis of hyperprolactinemic patients[J].Kaohsiung J Medl Sci,2012,28(2):94-99.
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[11]Suliman AM,Smith TP,McKenna TJ,et al.Frequent misdiagnosis and mismanagement of hyperprolactinemic patients before the introduction of macroprolactin screening:application of a new strict laboratory definition of macroprolactinemia[J].Clin Chem,2003,49(9):1504-1509.
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[13]Cavaco B,Leite V,Sobrinho LG.Some forms of big big prolactin behave as a complex of monomeric prolactin with an immunoglobulin G in patients with macroprolactinemia or prolactinoma[J].J Clin Endocrinol Metab,1995,80(8):2342-2346.
[14]Hattorl N,Inagakl C.Anti-prolactin(PRL)autoantibodies cause asymptomatic hyperprolactinemia:bioassay and clearance studies of PRL-immounoglobulin G complex[J].J Clin Endocrinol Metab,1997,82(9):3107-3110.
[15]Sapin R,Gasser F,Grucker D.Free prolactin determinations in hyperprolactinemic men with suspicion of macroprolactinemia[J].Clin Chim Acta,2002,316(1-2):33-41.
[16]Krysiak R,Kowalska B,Okopien B,et al.The effect of oral contraception on macroprolactin levels in women with macroprolactinemia:a pilot study[J].Pharmacol Rep,2015,67(5):854-857.
[17]Thirunavakkarasu K,Dutta P,Sridhar SA,et al.Macroprolactinemia in hyperprolactinemic infertile women[J].Endocrine,2013,44(3):750-755.
[18]Hattori N,Ikekubo K,Nakayama Y,et al.Immunoglobulin G subclasses and prolactin(PRL)isoforms in macroprolactinemia due to anti-PRL autobodies[J].J Clin Endocrinol Metab,2005,90(5):3036-3044.
[19]Lucille K,Thomas P,James G,et al.Characterrization of macroprolactin and assessment of makers of autoimmunity in macroprolactinaemic patients[J].Clin Endocrine,2008,70(4):599-605.
[2]Vallette S,Morange I,Selim A,et al.Macroprolactinemia revisited:a study on 106patients[J].J Clin Endocrinol Metab,2002,87(2):581-588.
[3]Chen Y,Wang H,Yang W,et al.A new method of using polyethylene glycol(PEG)precipitation of macroprolactin to detect genuine hyperprolactinemia[J].J Clin Lab Anal,2016,30(6):1169-1174.
[4]Krysiak R,Drosdzol A,Okopien B,et al.Sexual function and depressive symptoms in young women with elevated macroprolactin content:apilot study[J].Endocrine,2016,53(1):291-298.
[5]Park YM,Lee SH,Lee BH,et al.Prolactin and macroprolactin levels in psychiatric patients receiving atypical antipsychotics:apreliminary study[J].Psychiatry Res,2016,239(3):184-189.
[6]Chen YJ,Song GZ,Wang ZN.A new criteria for screening macroprolactinemia using polyethylene glycol treatment combined with different assays for prolactin[J].Eur Rev Med Pharmacol Sci,2016,20(9):1788-1794.
[7]Sadideen H,Swammathan R.Macroprolatcin:What is it and what is its importance[J].Int J Clin Pract,2006,60(4):457-461.
[8]Fahie-Wilson M,Brunsden P,Surrey J,et al.Macroprolactin and the roche elecsys prolactin assay:characteristics of the reaction and detection by precipitation with polyethylene glycol[J].Clin Chem,2000,46(12):1993-1995.
[9]Lu CC,Hsieh CJ.The importance of measuring macroprolactin in the differential diagnosis of hyperprolactinemic patients[J].Kaohsiung J Medl Sci,2012,28(2):94-99.
[10]Fahie-Wilson M.The macroprolactinemia problem and its solution[J].South Med J,2006,99(11):1206.
[11]Suliman AM,Smith TP,McKenna TJ,et al.Frequent misdiagnosis and mismanagement of hyperprolactinemic patients before the introduction of macroprolactin screening:application of a new strict laboratory definition of macroprolactinemia[J].Clin Chem,2003,49(9):1504-1509.
[12]Hattori N,Ishihara T,Ikekubo K,et al.Autoantibody to human prolactin in patients with idiopathic hyperprolactinemia[J].J Clin Endocrinol Metab,1992,75(5):1226-1229.
[13]Cavaco B,Leite V,Sobrinho LG.Some forms of big big prolactin behave as a complex of monomeric prolactin with an immunoglobulin G in patients with macroprolactinemia or prolactinoma[J].J Clin Endocrinol Metab,1995,80(8):2342-2346.
[14]Hattorl N,Inagakl C.Anti-prolactin(PRL)autoantibodies cause asymptomatic hyperprolactinemia:bioassay and clearance studies of PRL-immounoglobulin G complex[J].J Clin Endocrinol Metab,1997,82(9):3107-3110.
[15]Sapin R,Gasser F,Grucker D.Free prolactin determinations in hyperprolactinemic men with suspicion of macroprolactinemia[J].Clin Chim Acta,2002,316(1-2):33-41.
[16]Krysiak R,Kowalska B,Okopien B,et al.The effect of oral contraception on macroprolactin levels in women with macroprolactinemia:a pilot study[J].Pharmacol Rep,2015,67(5):854-857.
[17]Thirunavakkarasu K,Dutta P,Sridhar SA,et al.Macroprolactinemia in hyperprolactinemic infertile women[J].Endocrine,2013,44(3):750-755.
[18]Hattori N,Ikekubo K,Nakayama Y,et al.Immunoglobulin G subclasses and prolactin(PRL)isoforms in macroprolactinemia due to anti-PRL autobodies[J].J Clin Endocrinol Metab,2005,90(5):3036-3044.
[19]Lucille K,Thomas P,James G,et al.Characterrization of macroprolactin and assessment of makers of autoimmunity in macroprolactinaemic patients[J].Clin Endocrine,2008,70(4):599-605.