巨泌乳素干扰高泌乳素血症诊断的临床研究

目的：探讨高泌乳素血症中巨泌乳素（MPRL）对泌乳素（PRL）检测的干扰及应用聚乙二醇（PEG）筛查MPRL的可行性。方法：200例高泌乳素血症患者按临床表现和影像学资料分为垂体性高泌乳素血症组（100例）、功能性高泌乳素血症组（100例），正常对照组（100例）。采用拜耳ACS180全自动化学发光免疫检测仪检测各组血清PEG处理前、后的PRL值。以回收率≤40％为判断MPRL的临界值。结果：各组间血清PRL处理前、后结果有统计学差异（P〈0．05）；各组巨泌乳素血症发生率分别为3％、25％和1％。高泌乳素血症中巨泌乳素血症的总发生率为14％。高泌乳素血症患者含有MPRL，明显的影响PRL的检测。其中以功能性高泌乳素血症的影响较大。结论：应用PEG去除MPRL的干扰是可行的．它有助于临床高泌乳素血症的正确诊断和治疗。

The clinical research on the interference of macroprolactin on diagnosis in hyperprolactinemia

Objective： To explore the existence of macroprolactin （MPRL） in the blood samples of patients with hyperprolactinemia（HPRL）, determine the extent of MPRL interfere on prolactin （PRL） assay, and analyze the feasibility of applying polyethylene glycol （PEG） treatment in the screening test for MPRL. Methods： We classified 200 hyperprolactinemic patients ,on a clinical and imaging basis,into two groups：A pituitary lesions hyperprolactinemia; B functional hyperprolactinemia. And a control group was consisted of 100 healthy persons. PRL was measured by Bayer ACS 180 prior to and after PEG serum treament. A PRL recovery rate of ≤ 40% was an indication of macroprolactinemia. Results： The serum PRL levels measured between groups were significantly different before and after PEG treatment （P〈0.05）.The incidence of macorprolactinemia of each group were 3% ,25% ,1%, respectively.The total incidence of macorprolactinemia in the HPRL was 14%. The presence of MPRL had influence on the determination of PRL, especially in functional hyperprolactinemia. Conclusion： The use of PEG immunoprecipitation procedure may be a particular important method that eliminates MPRL interference from PRL immunoassays.