progesterone

Progesterone (P) is a 21C steroid hormone, which is converted from cholesterol by pregnenolone via isomerase. In non-pregnant women, the ovarian follicular cells produce P. During pregnancy, P is mainly secreted by the placental syncytiotrophoblast layer, so the blood P level is mainly related to placental weight and blood perfusion. It rises slowly in the first trimester, increases after 13 weeks, and peaks at full term. In the blood, P is mainly combined with corticosteroid-binding protein (CBG) and albumin, and most of the blood P is bound, and very few are free. Progesterone is mainly degraded in the liver and reduced to progesterone. The progesterone is then combined with sulfuric acid or glucuronic acid and excreted in the kidney. P has important physiological effects on regulating menstrual cycle and maintaining pregnancy, can promote the transformation of endometrial secretory phase, prepare for implantation of fertilized egg; relax uterine muscle, reduce reactivity to prostaglandins and oxytocin; inhibit fallopian tube rhythm Sexual contraction. P also promotes breast acinar hyperplasia, increases energy metabolism, increases basal body temperature, and promotes the elimination of sodium and water. P has positive and negative feedback effects on the hypothalamic-pituitary system, which can regulate the synthesis and secretion of pituitary gonadotropins. Before the ovulation, the low-dose progesterone synergized with E3 to induce the peak of LH before ovulation. After ovulation, the large dose of P showed negative feedback to the hypothalamic-pituitary system. Basic Information Specialist classification: gynecological examination classification: blood examination Applicable gender: whether women are fasting: fasting Analysis results: Below normal: Primary or secondary amenorrhea, premature delivery, infertility, ectopic pregnancy or luteal insufficiency may have a decrease in serum P. Normal value: Blood progesterone (follicular phase): 0-6nmol/L Blood progesterone (luteal phase): 20-90 nmol/L Above normal: (1) Twin or multiple pregnancy Due to the increase of placental volume, P secretion increased, serum P level was significantly higher than single pregnancy. (2) Patients with congenital 17α-hydroxylase deficiency have decreased serum P levels due to decreased P degradation. (3) In the case of pregnancy-induced hypertension, endometrial adenoma, etc., blood P increased. negative: Positive: Tips: After taking the specimen, the lid should be tightly closed and stored in a refrigerator at 4 °C. Normal value Female follicular phase, 6nmol / L; luteal phase, 20 ~ 90nmol / L. Clinical significance 1, twin or multiple pregnancy due to increased volume of placenta, P secretion increased, serum P levels were significantly higher than single pregnancy. 2, patients with congenital 17α-hydroxylase deficiency due to decreased P degradation, leading to elevated serum P levels. 3. In the case of pregnancy-induced hypertension and endometrial adenoma, the blood P is increased. 4, primary or secondary amenorrhea, premature delivery, infertility, ectopic pregnancy or luteal insufficiency can occur serum P decreased. Low results may be diseases: corpus luteum atrophy, ectopic pregnancy results may be high disease: multiple pregnancies precautions 1. The marked products and standard products are all prepared from anhydrous ethanol, which is easy to volatilize. The lid should be tightly packed and stored in a refrigerator at 4 °C. 2, anti-serum should be stored at 4 ° C after dilution into mother liquor, do not put -20 ° C low temperature, so as not to freeze and thaw, reduce anti-serum titer. 3, gelatin, activated carbon, dextran and other reagents should be placed in a dry place. 4, 0.1% GPS in the summer, even if placed at 4 ° C, it is easy to deteriorate, it is best not to allocate too much at a time. If it is found that the turbidity, odor and other deterioration phenomena, it should be re-allocated. 5. When performing B and F separation, the sample should maintain a constant contact adsorption time due to DCC. Therefore, the number of batching tubes should not be too much, and the time should not be too long. The control should be added within 3 to 5 minutes. After separation, add the second batch. 6. When extracting activated carbon solution (DCC), it is necessary to ensure sufficient mixing of the DCC solution to avoid the separation effect due to the uneven concentration of DCC. 7. The extraction of CH2Cl2 and the anhydrous ethanol for preparation must be re-steamed and used. Inspection process 1. Standard curve production: 0, 10, 20, 50, 100, 200, 400pg (re-pipe), 60 ° C water bath compressed air blow dry, add progesterone 11000dpm / 20μl blow dry, each tube plus 1:5 10,000 0.2ml antibody, 4 °C constant temperature overnight, the next day plus 5g / LGPS0.1ml, 2.5g / LDCC0.5ml, placed at 4 ° C for 10min, centrifuged at 3000r / min for 10min, aspirate supernatant 0.4ml, added to 8ml scintillation fluid, The mixture was mixed for 1 min, and was exposed to light for 4 hours. Another four tubes were added, each adding 3H-progesterone 11000 dpm/20 μl, blown dry, plus 1 g/L, and the two tubes of GPS were used for total pulse (T). The other tube was used as a non-specific assay tube (BN%), and the BN% DCC separation method was prepared with the standard curve. 2, the detection of unknown samples: pregnant women take plasma 0.05ml or 0.1ml, pregnant women or males take 0.2ml, in the test tube with heavy distilled water to make up 0.5ml, add 0.1mol / L NaOH 0.2ml, re-distilled dichloromethane 5ml, extract for 5min, let stand, discard the supernatant, dilute with dichloromethane twice, each time 1ml, wash, centrifuge at 1500r/min for 3min, take up 2ml of dichloromethane extract, set 45°C water bath Evaporate to dryness, add 3H-progesterone 11000 dpm/10 μl, blow dry, add 0.2 ml of 1:50,000 antibody, the following operation is the same as the standard curve. Not suitable for the crowd People with reduced hematopoietic function such as leukemia, various anemia, myelodysplastic syndrome, or people with thrombocytopenia should pay attention to blood draw, and should not take more or more blood. Adverse reactions and risks 1. After the blood is drawn, do not press the needle hole to avoid subcutaneous hematoma. If there is a small piece of bruise in the blood, it is slightly tender, please don't panic, you can do hot compress after 24 hours to promote the absorption of blood. The general small amount of congestion will gradually absorb in 3 to 5 days and the color will become lighter and return to normal. 2, after the blood draw symptoms of dizziness such as: dizziness, vertigo, fatigue, etc. should immediately lie flat, drink a small amount of sugar water, and then undergo a physical examination after the symptoms are relieved.

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