性激素檢驗報告解讀

性激素檢驗報告解讀解讀性激素的化驗報告應按照一定順序和步驟進行，如下。FSH→黃體生成素和卵泡刺激素的比例→睾酮→PRL（泌乳素）→雌二醇→孕激素。（1）FSH與LH。◆ FSH一般情況：最低點位於黃體期：0.5 IU/L，最高點位於排卵期：<20 IU/L。臨床意義：低於1 IU/L提示下丘腦—垂體功能低下；高於20 IU/L提示卵巢功能衰竭◆LH一般情況：最高點位於排卵期，可高於20 IU/L。最高點位於排卵期：<20 IU/L。臨床意義：若LH 13~25 IU/L，FSH正常，則提示PCOS。早、中卵泡期升高更有意義，測尿LH峰，可預測排卵。（2）LH與FSH的比例。LH比FSH主要用於推斷黃體功能。若>2.5，考慮多囊卵巢或黃體功能不全；若<1，考慮HPO衰退的可能性。（3）睾酮。正常女性睾酮濃度為0.5-3.0 nmol/l，異常為>100 ng/dl。約80%的睾酮與SHBG（性激素結合球蛋白）結合，睾酮50%來源於外周雄烯二酮轉換，另外各25%來自腎上腺和卵巢。（4）PRL。泌乳素一天當中分泌水平有波動(5~27ng/ml)，每24小時，卵泡晚期約14個脈衝，黃體晚期約9個脈衝。泌乳素存在晝夜節律。另外應激（靜脈穿刺）可導致分泌增加。因此抽血時機應在上午9~11點，禁食、安靜狀態下。高泌乳素血症診斷標準為兩次>30ng/ml或880mIU/L。所測PRL包括小分子、大分子的PRL，大分子PRL無功能。部分正常婦女PRL可偏高。若月經正常，則可觀察；若閉經或月經稀發，則需要複測。（5）E2。雌二醇是體內最具有生理活性的雌激素，它的波動範圍大，為50-500pg/ml，有兩個峰值，一個在排卵前期，一個在黃體的中期。如果低於正常值並伴有FSH、LH低下，應考慮下丘腦性閉經。（6）孕酮。測定時機：下次月經前的5~8天目的：判斷有無排卵，>30nmol/l即提示排卵。孕酮與胎盤生長密切相關。存在近期子宮穿孔時，孕酮濃度分別為早孕30~45 nmol/，中孕70~150 nmol/l，晚孕150~600 nmol/l，與新生兒出生體重、胎盤重量有關。總體而言，激素水平的測定要把握好測定時機，早卵泡期（月經第2—4天）檢測最好，可以較好地反應下丘腦—垂體—卵巢軸的功能，並不要孕激素撤退以後檢測。附表：女性激素檢查詳細分析一覽表測定時間標本舊制單位正常值係數法定單位正常值新→舊係數雌激素總量 (E0)青春前期尿0-5μg/24h?0-5μg/24h?卵泡期尿4-25μg/24h?4-25μg/24h?排卵期尿28-100μg/24h?28-100μg/24h?黃體期尿22-80μg/24h?22-80μg/24h?妊娠期尿<45 000μg/24h?<45 000μg/24h?絕經期尿<10μg/24h?<10μg/24h?雌 酮 (E1)青春期血0-80pg/ml3.70-296pmol/L0.27卵泡期血20-150pg/ml3.774-555pmol/L0.27絕經期血31.4-36.2pg/ml3.7116-134pmol/L0.27妊娠晚期血0.5-0.9mg/dl3.718.5-33.3μmol/L0.27排卵期尿11-31μg/24h3.741-115nmol/24h0.27黃體期尿10-23μg/24h3.737-85nmol/24h0.27絕經期尿1-7μg/24h3.74-26nmol/24h0.27雌二醇 (E2)卵泡期血10-90pg/ml3.6737-330pmol/L0.272排卵期血100-500pg/m13.67367-1835pmol/L0.272黃體期血50-240pg/ml3.67184-881pmol/L0.272絕經期血10-30pg/ml3.6737-110pmol/L0.272妊娠晚期血0.2-1.7mg/dl3.677.34-62.4umol/L0.272卵泡期尿0-3pg/24h3.670-11nmol/24h0.272排卵期尿4-14pg/24h3.6715-51nmol/24h0.272黃體期尿4-l0pg/24h3.6715-37nmol/24h0.272絕經期尿0-4pg/24h3.670-15nmo1/24h0.272雌二醇 (E3)孕26周血5.45士0.5ng/ml3.4719.2土1.7nmol/L0.288孕27-28周血5.99士1.36ng/ml3.4720.8土4.7nmol/L0.288孕29-30周血6. 14土1.1ng/ml3.4721.3士3.8nmo1/L0.288孕31-32周血6.37士1.66ng/ml3.4722.0士5.8nmo1/L0.288孕33-34周血7.59土1.44ng/ml3.4726.3士5.0nmol/L0.288孕35-36周血10.16土2.29ng/ml3.4735.2士7.9nmol/L0.288孕37-38周血12.05士2.29ng/ml3.4745.3土7.9nmol/L0.288孕39-40周血15.52土3.3ng/ml3.4753.8土11.4nmol/L0.288孕41-42周血16.25土3.17ng/ml3.4756.4土11.0nmol/L0.288孕43… 周血13.61士3.93ng/ml3.4747.2士13.6nmol/L0.288孕28-29周尿8.9土2.6mg/24h3.4730.9士9.0μmol/24h0.288孕30-31周尿11.5土3.9mg/24h3.4739.9土13.5μmol/24h0.288孕32-33周尿15.1土5.3mg/24h3.4752.4士18.4μmol/24h0.288孕34-35周尿17.9土6.1mg/24h3.4762.1土21.2μmol/24h0.288孕36-37周尿22.0土5.2mg/24h3.4776.3士18.0μmol/24h0.288孕38-39周尿25.6土6.9mg/24h3.4788.8土23.9μmol/24h0.288孕40-41周尿25.9土6.9mg/24h3.4789.8士23.9μmol/24h0.288孕42-43周尿24.0土6.5mg/24h3.4783.2土22.5μmol/24h0.288孕44… 周尿19.5土6.5mg/24h3.4767.6士22.5μmol/24h0.288足月妊娠羊水遊離56.1ng/ml結合932 ng/ml3.47194.6 nmol/L3232 nmol/L0.288孕酮 （P）卵泡期血0.2-0.6ng/ml3.180.6-1.9 nmol/L0.3145黃體期血6.5-32.2ng/ml3.1820.7-102.4 nmol/L0.3145孕7周血24.5士7.6ng/ml3.1276.4士23.7 nmol/L0.32孕8周血28.6土7.9ng/ml3.1289.2士24.6 nmol/L0.32孕9- 12周血38.0士13.0ng/ml3.12118.6士40.6 nmol/L0.32孕13-16周血45.5土14.0ng/ml3.12142.0士43.7 nmol/L0.32孕17-20周血63.3士14.0ng/ml3.12197.5士43.7 nmol/L0.32孕21-24周血110.9土35.7ng/ml3.12346.0士111.4 nmol/L0.32孕25-34周血165.3士35.7ng/ml3.12514.8士111.4 nmol/L0.32孕35周血202.0土47.0ng/ml3.12630.2士146.6 nmol/L0.32絕經期血＜1.0ng/ml3.18＜3.20 nmol/L0.3145孕13-36周羊水55ng/ml3.12171. 6 nmol/L?足月妊娠羊水26ng/ml3.1281.1 nmol/L?孕二醇 (P2)卵泡期尿＜1.0mg/24h3.12＜3μmol/24h0.32黃體期尿2-7mg/24h3.126-22μmol/24h0.32孕16周尿5-21mg/24h3.1216-65μmol/24h0.32孕24周尿12-32mg/24h3.1237-100μmol/24h0.32孕32周尿22-66mg/24h3.1269-205μmol/24h0.32孕36周尿13-77mg/24h3.1241-240μmol/24h0.32孕40周尿23-63mg/24h3.1272-197μmol/24h0.32絕經後尿0.2-1.0mg/24h3.120.6-3.1μmol/24h0.32孕三醇 （P3）成年女性尿0.5-2.0mg/24h2.971.5-5.9μmol/24h0.3365睾酮 (T)成年女性血59士22ng/ml0.03472.1士0.8 nmo128.8卵泡期血＜0.4ng/ml3.47＜1.4 nmol/L0.288排卵期血＜0.6ng/ml3.47＜2.1 nmol/L0.288黃體期血＜0.5ng/ml3.47＜1.7 nmol/L0.288絕經期血＜0.35ng/ml3.471.2 nmol/L0.288成年女性尿2-12μg/ml3.477-42nmo1/24h0.288＞50歲女性尿2-8μg/ml3.477-28 nmo1/24h0.288脫氫表雄酮 ( DHA)成年女性血2.0-5.2ng/ml3.476.0-18.0 nmo1/L0.288成年女性尿0-1.2mg/24h3.470-4.2μmo1/24h0.288硫酸脫氫表雄酮 (DHAS)成年女性血82-338μg/ml0.0262.1-8.8μmo1/L38.24絕經後血11-61μg/ml0.0260.3-1.6μmo1/L38.24卵泡刺激素 （FSH）卵泡期血0.66-2.20ng/ml10.66-2.20μg/L1排卵期血1.38-3.80ng/ml11.38-3.80μg/L1黃體期血0.41-2.10ng/ml10.41-2.10μg/L1月經期血0.50-2.50ng/ml10.50-2.20μg/L1正常女性血5-20mU/ml15-20 U/L1青春期前血＜5 mU/ml1＜5 U/L1絕經後血＞40 mU/ml1＞40U/L1卵泡期尿5-20U/24h15-20U/24h1排卵期尿15-16 U/24h115-16 U/24h1黃體期尿5-15 U/24h15-15 U/24h1月經期尿50-100 U/24h150-100 U/24h1黃體生成激素 (LH)卵泡期血5-30 mU/ml15-30U/L1排卵期血75-150 mU/ml175-150 U/L1黃體期血3-30 mU/ml13-30U/L1絕經期血30-130 mU/L130-130 U/L1卵泡期尿7.2-23.5 U/24h17.2-23.5 U/24h1β絨毛膜促性腺激素 （β-HCG）定性血/尿陰性?陰性?非孕時血＜3.1ng/ml1＜3.1 μg/L1孕7-10天血＞5.0 mU/ml1＞5.0U/L1孕30天血＞100 mU/ml1＞100 U/L1孕40天血＞2000 mU/ml1＞2000U/L1孕10周血50-100U/ml150-100kU/L1孕14周血10-20U/ml110-20 kU/L1滋養細胞疾病血＞100U/ml1＞100kU/L1胎盤生乳素 (HPL)非孕時血＜0.5μg/ml1＜0.5mg/L1孕22周血1.0-3.8μg/ml11.0-3.8 mg/L1孕30周血2.8-5.8μg/ml12.8-5.8 mg/L1孕42周血3.0-8.0μg/ml13.0-8.0 mg/L1催乳激素 (PRL)青春期前血8ng/ml18μg/L1育齡期血9-14ng/ml19-14μg/L1孕早期3月血＜80ng/ml1＜80μg/L1孕中期3月血＜160ng/ml1＜160μg/L1孕末期3月血＜400ng/ml1＜400μg/L1孕早期3月羊水血濃度的5-10倍???生長激素 (GH)臍帶血10-50ng/ml110-50μg/L1新生兒血15-40ng/ml115-40μg/L1兒童血＜20ng/ml1＜20μg/L1成年女性血＜10ng/ml1＜10μg/L1皮質醇 (C)非孕時血9-24μg/dl27.6248-660nmol/L0.036非孕時尿18.47士5.44μg/24h27.6509士150nmol/24h0.036孕時尿46.89士34.02μg/24h27.61293士938nmol/24h0.036孕10-15周羊水0.5μg/dl27.613.8nmol/L0.036孕35-37周羊水1.0μg/dl27.627.6nmol/L0.036臨產時羊水2.0-3.0μg/dl27.655.2-82.8nmol/L0.03617-羥類固醇 （17-OH）非孕時血9-21μg/dl27.6248-580nmol/L0.0362非孕時尿2-8mg/24h2.765.5-22.1μmol/24h0.362317-酮類固醇 （17-KS）非孕時尿6-15mg/24h3.4721-52nmol/L0.288孕時尿比非孕時高20%-100%???促腎上腺皮質激素 （ACTH）?上午8時 血5-50pg/ml0.221.1-11.0pmol/L4.54甲狀腺素 血 (T4)非孕時＞10歲血5-12μg/dl12.965-155nmol/L0.0777孕5月後血6.1-17.6μg/dl12.979-227nmol/L0.0777＞60歲女性血5.5-10.5μg/dl12.971-135nmol/L0.0777三碘甲狀腺原氨 (T3)非孕性＞15歲血115-190ng/dl0.01541.8-2.9nmol/L65.1孕時血140-275ng/dl0.01542.15-4.22nmol/L65.1＞60歲女性血108-205ng/dl0.01541.7-3.2nmol/L65.1醛固酮 血 （ALD）非孕時血0.015μg/dl2.80.042nmol/L0.357甲胎蛋白 (AFP)非孕時血2-16ng/ml12-16μg/L1孕20-21周血80.5士41.6ng/ml180.5士41.6μg/L1孕22-23周血85.8士47.8ng/ml185.8士47.8μg/L1孕24-25周血91.2士38.3ng/ml191.2士38.3μg/L1孕26-27周血152.0士86.0ng/ml1152.0士86.0μg/L1孕28-29周血137.4士51.2ng/ml1137.4士51.2μg/L1孕30-31周血143.9士29.4ng/ml1143.9士29.4μg/L1孕32-33周血154.3士51.7ng/ml1154.3士51.7μg/L1孕34-35周血148.0士60.9ng/ml1148.0士60.9μg/L1孕36-37周血121.8士59.0ng/ml1121.8士59.0μg/L1孕38-39周血116.7士67.4ng/ml1116.4士67.4μg/L1孕40… 周血104.6士66.4ng/ml1104.6士66.4μg/L1
推薦閱讀：