LC-MS/MS在临床内源性类固醇激素分析中的方法研究和应用进展

类固醇激素是一类由肾上腺和性腺分泌的微量高效能化学物质。类固醇激素的变化在新生儿筛查、内分泌疾病及相关代谢性疾病的诊断中具有重要参考价值。因此，寻找一种可靠、便捷的分析方法成为临床疾病诊断和治疗的首要任务。在各类检测方法中，液相色谱-质谱/质谱（LC-MS/MS）联用技术因具有高灵敏度、高专属性和高通量的特点，在临床类固醇激素代谢分析领域显示极大的潜力。本文综述了该技术在临床内源性类固醇激素分析方面的应用及进展，特别是样品前处理、色谱及质谱条件方面，并简要阐述LC-MS/MS在肾上腺皮质激素及性激素测定方面的特点及优势，从而为临床应用提供更快速准确的诊断依据。

Steroid hormones were trace and high-performance chemicals,which were secreted by the adrenal glands and gonads. The change of steroid hormones is an important reference for the neonatal screening and diagnose of endocrine and related metabolic diseases. As a result,a sensitive and specific analytical method is found of great significance in clinical diagnose and treatment. Among the various detection methods,liquid chromatography coupled with tandem mass spectrometry(LC-MS/MS) with its high sensitivity,specificity and throughput shows great potential in clinical steroid hormone metabolic analysis. This review summarized the application and progress of LC-MS/MS in the clinical endogenous steroid detection,especially the sample pretreatment,chromatography and mass spectrometry conditions. We also introduced the characteristics and advantages of LC-MS/MS in the determination of glucocorticoid and sex hormones,which could provide a more accurate diagnostic basis for the clinical application.