多囊卵巢综合征雄激素质谱检测专家共识

检验医学2023年3月第38卷第3期Laboratry Medicine,March2023,6l,38.No,3·203·文章编号：16738640(2023)03020306中图分类号：R446.1文献标志码：AD01:10.3969issn.1673-8640.2023.03.001多囊卵巢综合征雄激素质谱检测专家共识多囊卵巢综合征雄激素质谱检测共识专家组中国人体健康科技促进会生育力保护与保存专业委员会摘要：多囊卵巢综合征(PCOS)是常见的有龄期女性内分泌疾病，也是导致女性不孕的主要因素。PCOS病理生理的主要问题是高雄激素血症。高雄激素血症可以通过生化检验或临床表现进行评估。目前，大多临床实验室常规开展的基于免疫学的雄激素检测方法存在诸多缺陷，如交叉反应、检测低浓度样本时准确性差、不同品牌试剂检测结果缺乏可比性，导致高雄激素血症评估时出现假阳性结果。液相色谱串联质谱(LC-MSMS)其有灵敏度高、特异性强、线性范围宽、可多目标物同时检测等优势，是更高效的雄激素检测方法。基于临床和实验室循证医学证据，首都医科大学附属北京妇产医院和中国人体健康科技促进会生育力保护与保存专业委员会联合临床检验、妇科内分泌、质谱应用领域学者共同制定该专家共识，旨在为医疗机构开展PCOS雄激素检测提供建议指导。该专家共识的声明包括PCOS雄激素实验室检测项目和检测方法的建议，以及采用LC-MSMS检测雄激素的挑战与应对。关键词：多囊卵巢综合征；高雄激素血症；液相色谱串联质谱Consensus on androgen testing in polyeystic ovary syndrome Expert Group on the Consensus on AndrogenTesting in Polycystic Ovary Syndrome,China Association for Promotion of Health Science and Technology-FertilityProtection and Preservation Committee.Abstraet:Polycystic ovary syndrome (PCOS)is one of the most common endocrine disorders in reproductive-age females,frequently leading to female infertility.Hyperandrogenemia plays a role in the pathogenesis of PCOS.Hyperandrogenemia can be evaluated by biochemical tests or clinical signs.At present,there are some limitations ofimmunology-based testing methods for androgen,such as cross-reaction,poor accuracy in low-concentration samplesand lack of comparability among different reagent manufacturers.leading to false positivity.With the advantagesof high sensitivity,high specificity,wide linear range and the capability of simultaneous determination of multiplemolecules,liquid chromatography-tandem mass spectrometry (LC-MS/MS)becomes a good choice for androgentesting.On the basis of published clinical and laboratory evidence,Beijing Obstetrics and Gynecology Hospital ofCapital Medical University,China Association for Promotion of Health Science and Technology-Fertility Protectionand Preservation Committee,along with the experts in the clinical laboratory,gynecological endocrinology andmass spectrometry application relevant field made this consensus,in order to provide professional guidance in PCOSandrogen testing in clinical laboratories.The consensus includes recommendations on types and methods of androgentesting for PCOS and challenges of androgen testing with LC-MS/MS.Key words:Polycystic ovary syndrome;Hyperandrogenemia;Liquid chromatography-tandem massspectrometry1多囊卵巢综合征概述传和环境因索共同导致的一种常见的内分必代谢多囊卵巢综合征(polycystic ovary性疾病，其主要的临床表现为月经不调、不孕、syndrome,PCOS)即Stein-Leventhal综合征，高雄激素血症、卵巢多囊，可伴有肥胖、胰岛素于1935年被Stein和Leventhal首次报道，是由遗抵抗、血脂紊乱等代谢异常，并可导致2型糖尿基金项目：北京市医院管理中心“登峰”计划专项(DL20181401)通信作者：曹正，E-mail:hengcao201l@ccmu.cdu.cm;阮t样燕，E-mal:ruanxiang马an@ccmu.ed.cn。引用本文：多囊卵巢综合征雄激素质谱检测共识专家组，中国人体健康科技促进会生育力保护与保存专业委员会，多囊卵巢综合征雄激素质谱检测专家共识.检验医学，2023,38(3)：203-208.