Prolaktin, makroprolaktin uchun refleks
Kod:9018|CPT:84146|LOINC:2842-3, 42607-2, 51441-4
| Kabi | Prolaktin Makroprolaktin bo‘yicha refleks |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Elektrokimyoluminessent immunoanaliz (ECLIA)
- Polietilenglikol bilan presipitatsiya (PEG)
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
- For infants younger than 1 year, withhold feeds for 30–40 minutes before collection.
- For children 1–5 years, avoid food for 2–3 hours before collection.
- Adults should fast for 12 hours; water is permitted.
- With clinician approval, stop estrogens and androgens 48 hours before collection.
- With clinician approval, avoid all medications for 24 hours before collection if feasible.
- Avoid strenuous physical activity and significant emotional stress for 24 hours before collection.
- Do not smoke for 3 hours before collection.
- If prolactin exceeds the reference range, testing will reflex to macroprolactin at additional charge.
- If date of birth and/or sex are not provided, testing will reflex to macroprolactin regardless of prolactin results.
Qanday foydalanish
Prolaktin, makroprolaktin uchun refleks testi galaktoreya, amenoreya, anovulyatsiya, bepushtlik va prolaktin sekretsiya qiluvchi gipofiz adenomalaridan shubha kabi kontekstlarda giperprolaktinemiyani baholashni qo‘llab-quvvatlaydi. Belgilar prolaktin fiziologiyasining buzilishini ko‘rsatganda, u ayollar ham, erkaklar ham uchun maqsadga muvofiq. Prolaktin oshgan, ammo simptomlar minimal yoki yo‘q bo‘lganda, makroprolaktin (macro PRL, big-big prolactin) uchun refleks tekshiruv makroprolaktinemiyani chiqarib tashlash va bioaktiv monomerik prolaktin ortiqligini aniqlash uchun ko‘rsatiladi. Topilmalar gipofizni tasvirlash zarurati, terapevtik tanlovlar va prognozga yo‘naltiradi hamda ayollar va erkaklarda hayz ko‘rish buzilishlari va bepushtlikka hissa qo‘shuvchi omil sifatida makroprolaktinemiyani istisno qilishga yordam beradi.
Cheklovlar
Qon aylanishidagi prolaktinning asosiy qismi (~85%) bioaktiv bo‘lgan monomerik prolaktindan iborat; undan kichikroq fraksiyalar dimerik prolaktin (~10%) va makroprolaktin (~5%) ni tashkil etadi. Makroprolaktin taxminan ~200 kDa li prolaktin–IgG kompleksi bo‘lib, past biologik faollikka ega. Prolaktin gipofiz laktotrof hujayralari tomonidan ishlab chiqariladi va tonik dopaminergik tormozlanish ostida. Giperprolaktinemiya gipotalamo–gipofizar regulyatsiyaning buzilishi, birlamchi gipotiroidizm, surunkali buyrak kasalligi yoki gipofiz adenomalaridan kelib chiqishi mumkin. Dori bilan bog‘liq giperprolaktinemiya odatda dopamin antagonizmini aks ettiradi. Ayollarda namoyonlar hayz sikli buzilishlari, anovulyatsiya va galaktoreyani o‘z ichiga oladi; erkaklarda libido pasayishi va erektil disfunktsiya ko‘p uchraydi. Katta adenomalar bosh og‘rig‘i yoki ko‘rish buzilishlarini keltirib chiqarishi mumkin. Makroprolaktinemiya ko‘pincha buyrak klirensining kamayishi tufayli jami prolaktin konsentratsiyalarining ancha oshishi bilan kechadi, biroq makroprolaktin bioaktivligi pastligi sabab klinik simptomlar cheklangan bo‘ladi. Eng tez-tez uchraydigan klinik belgi — hayz ko‘rishning muntazam emasligi; galaktoreya va bepushtlik kamroq kuzatiladi. Gipofiz adenomalari kamroq aniqlanadi va mavjud bo‘lganda, odatda mikroadenomalar bo‘ladi. Faqat klinik namoyon bilan makroprolaktinemiyani haqiqiy giperprolaktinemiyadan ishonchli farqlab bo‘lmagani uchun, prolaktin oshganida makroprolaktin uchun refleks tekshiruv tavsiya etiladi.
| Referens oraliq |
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|---|---|---|---|---|---|---|---|---|---|---|
| Ko'rsatmalar | Assessment of elevated prolactin in women presenting with oligomenorrhea or amenorrhea, Workup of galactorrhea, Evaluation of female infertility or anovulation, Assessment of hyperprolactinemia in men with reduced libido or erectile dysfunction, Evaluation of male infertility, Investigation of asymptomatic hyperprolactinemia, Differentiation of true hyperprolactinemia from macroprolactinemia, Diagnostic evaluation of secondary amenorrhea |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- lactation
- pregnancy
- sexual activity
- stress
- strenuous exercise
Namunangiz talablari
| Namunangiz | Zardob |
|---|---|
| Container | Oltin/yo'lbars qopqoqli probirka (SST, gel ajratgich) |
| Hajm | 2 mL (min 1 mL) |
| Saqlash tayyorlik | Xona harorati, Sovutilgan, Muzlatilgan |
References
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