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甲氧氯普胺兴奋试验对高泌乳素血症的病因诊断价值及其影响因素

The value of metoclopramide stimulation test in etiological diagnosis of hyperprolactinemia and its influencing factors

  • 摘要: 目的:探讨甲氧氯普胺(胃复安)兴奋试验对高泌乳素血症的病因诊断价值,并分析可能的影响因素。方法:收集2013年11月至2015年3月在复旦大学附属华山医院内分泌科住院的53例临床确诊的高泌乳素血症患者。所有患者入院后均行胃复安兴奋试验和其他相关实验室检查,分析相关影响因素。结果:53例高泌乳素血症患者包括泌乳素瘤37例,其他病因16例。胃复安兴奋试验鉴别泌乳素瘤的灵敏度为81.08%,特异度为68.75%,准确度为77.36%;一致性检验Kappa值=0.481(P<0.05)。多元Logistic回归分析提示,胃复安兴奋试验兴奋与否与0 min泌乳素水平独立相关(OR=1.035,95%CI 1.011~1.059,P<0.001)。结论:胃复安兴奋试验对高泌乳素血症病因诊断具有较好的价值,但应考虑试验前泌乳素基线水平的影响。

     

    Abstract: Objective:To investigate the value of metoclopramide stimulation test in etiological diagnosis of hyperprolactinemia, and to analyze its possible influencing factors. Methods:Fiftythree patients with hyperprolactinemia treated in Department of Endocrinology of Huashan Hospital from November 2013 to March 2015 were enrolled. The metoclopramide stimulation test and the other related laboratory tests were performed to analyze the factors affecting test results. Results:In all the 53 hyperprolactinemia patients, 37 patients were diagnosed with prolactinoma. The diagnostic sensitivity of the metoclopramide stimulation test for hyperprolactinemia was 81.08%, the specificity was 68.75%, and the accuracy was 77.36%. The consistency test showed a Kappa value as 0.481 (P<0.05). The result of metoclopramide stimulation test was independently associated with the prolactin level at 0 min (OR=1.035,95%CI 1.011-1.059,P<0.001).Conclusions:The metoclopramide stimulation test has significant value in the etiological diagnosis of hyperprolactinemia. However, the result of metoclopramide stimulation test may be affected by the baseline of the prolactin level.

     

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