Honour John W
Clinical Biochemistry, University College London Hospitals, London, England.
J Clin Res Pediatr Endocrinol. 2010;2(1):1-16. doi: 10.4274/jcrpe.v2i1.1. Epub 2010 Feb 1.
Most steroid disorders of the adrenal cortex come to clinical attention in childhood and in order to investigate these problems, there are many challenges to the laboratory which need to be appreciated to a certain extent by clinicians. The analysis of sex steroids in biological fluids from neonates, over adrenarche and puberty present challenges of specificities and concentrations often in small sample sizes. Different reference ranges are also needed for interpretations. For around 40 years, quantitative assays for the steroids and their regulatory peptide hormones have been possible using immunoassay techniques. Problems are recognised and this review aims to summarise the benefits and failings of immunoassays and introduce where tandem mass spectrometry is anticipated to meet the clinical needs for steroid analysis in paediatric endocrine investigations. It is important to keep a dialogue between clinicians and the laboratory, especially when any laboratory result does not make sense in the clinical investigation.
大多数肾上腺皮质类固醇疾病在儿童期引起临床关注，为了研究这些问题，实验室面临诸多挑战，临床医生需要在一定程度上了解这些挑战。对新生儿、肾上腺初现期和青春期生物体液中的性激素进行分析，常常面临特异性和浓度方面的挑战，且样本量往往较小。解释结果还需要不同的参考范围。大约40年来，一直可以使用免疫测定技术对类固醇及其调节肽激素进行定量测定。问题是公认的，本综述旨在总结免疫测定的优点和不足，并介绍串联质谱法预计在儿科内分泌研究中满足类固醇分析临床需求的领域。临床医生和实验室之间保持对话很重要，尤其是当任何实验室结果在临床研究中不合理时。
