摘要
目的 探讨实验室测量雌二醇(E2)水平假性升高的原因。方法 通过回顾性分析2例假性E2升高的病例,比较多种仪器测定的E2水平,尝试分析E2假性升高的原因。结果 (1)病例1为10.8岁男性患儿,因“中枢性性早熟”就诊,期间多次利用化学发光法(贝克曼DX1800)测量血清E2明显升高达312.0~531.7pmol/L。应用芳香化酶抑制剂(来曲唑)后,E2水平未下降。改用不同仪器(化学发光法)测定E2水平,部分仪器的检测结果E2浓度低于可测定值下限。(2)病例2为10岁女性患儿,因“身材增长迟缓”就诊,多次检测E2明显升高达469.8~690.0pmol/L。将同一血清标本送至不同仪器进行测定,部分仪器的检测结果显示E2水平低于可测定值下限。结论 当测定的E2水平升高与临床表现不一致时,临床医生应考虑到E2假性升高的可能。性激素结合蛋白(SHBG)、药物、异嗜性抗体(HA)、人抗动物抗体、自身抗体,以及不同的检测仪器和试剂、不同的检测方法等因素,均可能引起E2水平测定异常。对同一份血清,选择不同仪器进行测定,有助于明确E2的真实水平。
Objective : To explore the causes of falsely elevated estradiol(E 2). Methods : Two cases with high concentration of serum E 2 were retrospectively investigated. The values of E 2 were measured by different apparatuses and commercial available kits. Results :(1) Case 1 was a 10.8 years old boy. He presented with central precocious puberty. E 2 levels were repeatedly measured by chemiluminescence(Beckman DX1800),and the E 2 concentration was 312.0-531.7 pmol/L. Aromatase inhibitor(letrozole) was administrated,but E 2 concentration was not decreased. Then,different instruments(chemiluminescence method) were applied to measure the E 2 level,and the detection result of some instruments was even lower than the lower limit of the measurable value.(2) Case 2 was a 10 years old girl. She was admission for evaluation of short stature. Repeated E 2 values were 469.8-690.0 pmol/L. Then,the different apparatuses and commercial kits were used to measure the E 2 level for the same serum sample,and the detection result of some instruments was even lower than the lower limit of the measurable value. Conclusions : When the measured elevated E 2 levels are inconsistent with clinical manifestations,clinicians should consider the possibility of a false increase in E 2. Falsely elevated serum E 2 concentrations can be caused by sex hormone binding protein(SHBG),drugs,heterophilic antibody,anti-animal antibody,auto immune antibody,different assay methods,and even different apparatus and kits. For the same serum sample ,the choice of different instruments for determination will help to clarify the true level of E 2.
作者
李淑颖
王林杰
陈适
陈歆琦
王曦
聂敏
伍学焱
茅江峰
LI Shu-ying;WANG Lin-jie;CHEN Shi;CHEN Xin-qi;WANG Xi;NIE Min;WU Xue-yan;MAO Jiang-feng(Division of Endocrinology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730;Division of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730)
出处
《生殖医学杂志》
CAS
2019年第6期588-592,共5页
Journal of Reproductive Medicine
基金
国家重点研发计划项目(2016YFC0905102,2016YFA0101003)
关键词
干扰
雌二醇
测定
诊断
化学发光法
Interference
Estradiol
Measurement
Diagnosis
Chemiluminescence
