人绒毛膜促性腺激素的检测及应用

人绒毛膜促性腺激素（HCG）是由胎盘滋养层细胞分泌的糖蛋白激素,由Ot、B两个亚基亦非共价键结合它存在于正常妊娠妇女的血液、尿、初乳、羊水和胎儿体内。α亚基为垂体前叶激素所共有,β亚基是HCG所特有的。其主要功能就是刺激黄体,有利于雌激素和黄体酮持续分泌,以促进子宫蜕膜的形成,使胎盘生长成熟。在妊娠的前八周增值很快,以维持妊娠,在大约八周以后,HCG逐渐下降,直到大约二十周达到相对稳定。     

动态监测血清人绒毛膜促性腺激素在妇科疾病诊疗中的应用

目的：探讨动态监测血人绒毛膜促性腺激素（β-HCG）在早孕及妇科疾病诊治中的意义。方法应用化学发光法动态监测75例具有妇科疾病指征的患者血中β-HCG值,其中早期妊娠组16例;先兆流产组39例（其中保胎治疗有效组17例、难免流产组22例）;异位妊娠组14例及典型葡萄胎治疗有效组6例。根据不同指征选择不同的监测时间点,以达到动态监测的目的。结果正常早期妊娠组首次100%血β-HCG〉3mIU/ml,间日量比首次具有渐高或成倍增高趋势;其他滋养层细胞疾病组根据孕周具体的采血时间及治疗前后不同时间点采血,其β-HCG值具有渐长或渐降的动态趋势。结论动态监测血β-HCG可作为早期妊娠、先兆流产、异位妊娠及滋养细胞疾病的诊断、治疗及随访疗效的监控指标。     

早早孕试纸条对血清人绒毛膜促性腺激素定量的协同检测

目的：了解早早孕试纸条在血清人绒毛膜促性腺激素（HCG）定量检测中的协同作用。方法在对血清HCG定量分析之前,先用胶体金早早孕检测试纸了解标本中血清HCG大致浓度范围,再决定是否稀释及稀释倍数,从而可以准确、快速测出结果。结果根据早早孕试纸条显色结果对标本进行稀释,一次检出率可达到96%。结论用HCG胶体金定性试纸条先对血清标本进行检测,来了解标本是否需要稀释,需要稀释的标本根据试纸条的显色结果来判断稀释倍数。这对节约成本,减少工作量很有帮助。     

血清游离人绒毛膜促性腺激素β亚基检测及临床应用

人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)是由胎盘合体滋养细胞所分泌的、由α和β亚基通过非共价键组成的糖蛋白激素,相对分子质量为37.5×103.除整分子HCG外,可在血浆、血清和尿中检测到HCG的亚基(游离α、β亚基)和游离亚基的降解产物[1-2].     

2型糖尿病患者血脂、尿微量白蛋白和尿N—乙酰—β—D氨基葡萄糖苷酶变化与血糖控制的关系

目的 了解2型糖尿病患血脂，尿微量白蛋白（mAlb)和尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）变化与血糖控制的关系。方法 对87例2型糖尿病患测定糖化血红蛋白（GHbAlc)。尿微量白蛋白（mAlb)。尿N-乙酰-β-D氨基葡萄糖苷酶（NAG）。胆固醇（TC），甘油三酯（TG），LDL-胆固醇（LDL-C），HDL-胆固醇（HDL-C），3月后复测。根据GhbAlc变化分为3组；血糖控制改善组24例，血糖控制无明显改善组37例；血糖控制良好组26例。结果 血糖控制改善组3月后GhbAlc,TG,NAG水平显降低；血糖控制无明显改善组TC，TG，LDL-C和NAG水平显升高；血糖控制良好组mAb显降低。结论 2型糖尿病患mAlb与NAG正相关；NAG与GhbAle正相关，改善血糖控制对TG，NAG，mAlb有一定的改善作用；血糖控制不满意可加重血脂代谢紊乱，升高NAG。     

早孕试纸条对雅培 AxSYM 检测血清β-人绒毛膜促性腺激素稀释模型研究

目的：探讨早孕试纸条对雅培 AxSYM 检测血清β-人绒毛膜促性腺激素（β-hCG）稀释模型以及应用。方法对该院5年间5612例妇科门诊和住院患者的血清β-hCG 检测结果进行回顾性分析。此外,收集234例患者血清,通过早孕试纸条定性检测初步确定血清β-hCG 浓度,再采用雅培 AxSYM 定量测定血清β-hCG 浓度。结果回顾性分析表明,低龄孕妇241例（4．6％）。定性筛查很有必要,成功建立筛查模型,但需要注意使用过程需要取出一部分血清置于另一管中进行测定。结论建立合理有效的早孕试纸条筛查血清β-hCG 稀释判读模型,可为雅培 AxSYM 检测系统日常检验工作带来经济和时间效益。     

尿β2-MG、Alb在儿童肾脏疾病的检测及临床应用

目的 :检测儿童肾脏疾病患者尿中 β2 -微球蛋白可早期发现患儿肾脏损伤程度 ,为临床诊断和治疗提供可靠的依据。方法 :采用微量、敏感的ELISA定量方法。结果 :肾病综合症组、肾炎组、过敏性紫瘢组 β2 -MG、Alb均显著高于正常儿童对照组。结论 :ELISA定量检测尿中 β2 -MG、Alb是早期检测肾脏损伤的一个简便、敏感、特异性强的指标。     

未成熟卵体外成熟与体外受精妊娠胚胎移植14d血清人绒毛膜促性腺激素β亚单位水平的比较

背景:相关研究表明,体外受精与胚胎移植治疗妊娠后血清人绒毛膜促性腺激素β亚单位水平对妊娠结局有预测作用,未成熟卵体外成熟治疗妊娠后血清人绒毛膜促性腺激素β亚单位水平对妊娠结局的预测作用不详.目的:比较不孕症患者体外受精与胚胎移植和未成熟卵体外成熟治疗妊娠后血清人绒毛膜促性腺激素β亚单位水平,探讨血清人绒毛膜促性腺激素β亚单位水平对未成熟卵体外成熟治疗妊娠患者的预测价值.方法:采用回顾性分析的方法,以在本中心行未成熟卵体外成熟治疗后妊娠实验阳性的42例患者为研究组,同期行体外受精治疗后妊娠实验阳性的66例患者作为对照组,比较两组患者胚胎移植后第14天血清人绒毛膜促性腺激素β亚单位水平.结果与结论:胚胎移植后14 d,分别在研究组和对照组内,单、双胎妊娠患者血清人绒毛膜促性腺激素β亚单位水平差异均有显著性意义.血清人绒毛膜促性腺激素β亚单位水平≥ 800 U/L时,两组双胎妊娠的发生率均明显增高.提示血清人绒毛膜促性腺激素β亚单位水平对未成熟卵体外成熟治疗后妊娠患者的结局具有预测价值,未成熟卵体外成熟/体外受精妊娠胚胎移植14 d血清人绒毛膜促性腺激素β亚单位水平及其对妊娠结局的预测是相同的.     

动态监测雌激素、孕酮、β-人绒毛膜促性腺激素在复发性流产中的临床意义

目的对复发性流产患者雌激素、孕酮、β-人绒毛膜促性腺激素(β-HCG)水平进行联合动态监测,评估先兆流产的预后,探讨其在习惯性流产中的临床意义。方法根据孕妇妊娠结局分为正常妊娠组和异常妊娠组,正常妊娠组62例,异常妊娠组58例。采集孕4~周、孕5~周、孕6~周、孕7~周、孕8~周、孕9~周孕妇血清并对血清雌二醇、孕酮及β-HCG进行测定。结果正常妊娠组血清雌二醇、β-HCG与孕周均呈显著正相关。相同孕周下,正常妊娠组与异常妊娠组相比,β-HCG与血清雌二醇多数有显著差异。结论在早孕期动态监测孕妇血清雌二醇与β-HCG是预测复发性流产患者再次妊娠结局有价值的生化指标,具有重要的临床意义。而利用孕酮预测复发性流产患者再次流产的价值有限。     

Discordant results in human chorionic gonadotropin assays.

Discordance has been reported in human chorionic gonadotropin (hCG) concentrations measured by different immunoassay kits. We examined the results for 40 serum samples assayed with 10 different hCG immunoassay kits. Results varied considerably. Individual sample results varied by as much as 58-fold. Average results for different kits varied by as much as 1.4-fold for pregnancy (20 samples) and 2.2-fold for trophoblast disease (20 samples) serum. We investigated the causes of this discordance. hCG or hCG beta are general names for mixtures of hCG, hCG alpha, or hCG beta immunoreactive molecules in serum. These mixtures include regular hCG, nicked hCG (missing peptide linkages at beta 44-45 or beta 47-48), carbohydrate variants of hCG, hCG missing the beta-subunit C-terminal segment, free beta-subunit, beta-core fragment, and free alpha-subunit. We prepared standards for each of these major variants and measured their reactivities in the 10 hCG immunoassay kits. Free beta-subunit reactivity varied from nonrecognition (anti-beta:anti-alpha type kits; Hybritech Tandem-R and others) to overrecognition (one kit had five-fold greater affinity for free beta than for hCG). Kits with antibodies to beta-subunit C-terminal segment (Organon NML and others) failed to recognize hCG missing this segment, a component of serum hCG in trophoblast disease. Kits with anti-hCG antibodies (Serono MAIA-clone and others) had minimal recognition of nicked hCG (12%), a component of all serum hCG samples, and consistently gave the lowest values with all serum samples. We conclude that differences in recognition of nicked hCG, free beta, and these other hCG variants cause discordance in hCG immunoassay results.     

Quantitation of whole molecule human chorionic gonadotropin and free beta-human chorionic gonadotropin subunit in the Abbott IMx analyser.

An assay for the quantitation of the serum levels of free and whole molecule-associated beta-subunit of human chorionic gonadotropin on the Abbott IMx analyzer is described. The assay detects human beta-chorionic gonadotropin with a sensitivity of approximately 0.5 IU/l while showing no cross-reactivity with follitropin (1000 IU/l) or thyrotropin (2.0 IU/l), and 0.02% cross-reactivity with lutropin (1000 IU/l). Haemoglobin (7.50 milligrams), bilirubin (0.50 milligrams), and triacylglycerols (10.6 milligrams) did not interfere with the assay. Pooled within-run, between-run, and total assay CVs were less than or equal to 5.2%, and less than or equal to 2.7%, and less than or equal to 6.3%, respectively. Values obtained with this assay correlated well (r = 0.98, n = 228) with those values obtained using the Hybritech TandemR-R HCG (Total Beta-HCG) IRMA. The normal range of the assay was found to be less than or equal to 5 IU/l (n = 311). The assay protocol provides results for up to 23 serum samples in approximately 47.5 minutes with the ability to report the human beta-chorionic gonadotropin concentrations of 5 specimens in approximately 15.5 minutes. We conclude that this is an acceptable assay for monitoring human beta-chorionic gonadotropin levels associated with normal pregnancy, reproductive pathology, and reproductive technology such as in vitro fertilization or embryo transfer.     

人绒毛膜促性腺激素在体内的存在形式及其临床应用

人绒毛膜促性腺激素(hCG)在妊娠、妊娠相关疾病及某些肿瘤的血、尿中以多种形式存在,包括规则hCG、缺口hCG、规则游离α亚基、大分子游离α亚基、规则游离β亚基、缺口游离β亚基、β亚基羧基末端丢失的hCG、高糖基化hCG,以及尿β核心片段等,各个分子形式以其自身不同的特点发挥不同的临床作用。对这些相关分子进行检测,对于妊娠及相关疾病的诊断与监测有重要临床意义。     

Metabolic and renal clearance rates of purified human chorionic gonadotropin.

The metabolic clearance rate (MCR) and renal clearance rate (RCR) of human chorionic gonadotropin (hCG) were measured in healthy young men and women using techniques of continuous intravenous infusion and rapid intravenous injection of unlabeled, highly purified hCG. Seven subjects received 4 d of infusion at a rate of 0.2 microgram/min, followed by an additional 4 d of infusion at 0.8 microgram/min. Mean serum levels of hCG established at these rates of infusion were 61.1 +/- 3.3 and 237 +/- 16 ng/ml, respectively (mean +/- SEM). The MCR determined at the low infusion rate was not significantly different from that determined at the higher infusion rate (1.83 +/- 0.09 vs. 1.95 +/- 0.14 ml/min per m2). The mean MCR for all subjects was 1.88 +/- 0.08 ml/min per m2. The MCR was not significantly different between men amd women (2.04 +/- 0.13 vs. 1.76 +/- 0.07 ml/min per m2). The RCR also did not vary between low and high infusion rates (0.40 +/- 0.03 vs. 0.40 +/- 0.04 ml/min per m2). The mean RCR for all subjects was 0.40 +/- 0.02 ml/min per m2. There was no difference in RCR between men and women (0.42 +/- 0.05 vs. 0.39 +/- 0.03 ml/min per m2). Six subjects were given 1.0 mg of highly purified hCG by rapid intravenous injection. Initial serum levels of hCG were 300-400 ng/ml, and the subsequent disappearance curve was multiexponential over 8-10 d. The disappearance curve of hCG in each subject was fitted to a biexponential equation. The rapid component t1/2 was 5.97 +/- 0.63 h and the slow component t1/2 was 35.6 +/- 8.0 h. We conclude that the MCR of purified hCG in man is about 2 ml/min per m2 and the RCR is 0.4 ml/min per m2; these parameters are concentration independent and do not differ significantly between healthy young men and women.     

Detection of desialylated forms of human chorionic gonadotropin

Urinary forms of human chorionic gonadotropin (hCG) with oligosaccharides deficient in sialic acid content (ashCG) have been reported to be excreted by patients with choriocarcinoma in greater amounts than by healthy, pregnant women. Although ashCG potentially could be a useful marker for the diagnosis and management of gestational trophoblastic neoplasia, the methods previously used for its detection were not suitable for routine clinical application. Therefore, we have devised a simpler method which can provide specific and sensitive measurements of ashCG in urine. This method, which is designated as a lectin-immunoradiometric assay (LIRMA), employs an agarose-coupled lectin to selectively extract the ashCG, which is then quantified directly with a purified and radiolabelled rabbit antibody. The LIRMA has been applied to demonstrate that there is an increased excretion of ashCG by choriocarcinoma patients. It is also applicable, in principle, for the study of any glycoprotein which has a reduced content of sialic acid in its carbohydrate side chains.