唾液皮质醇检测技术的研究进展与挑战

Salivary Cortisol Detection Technology: Current Investigations and Challenges

摘要: 唾液皮质醇作为下丘脑–垂体–肾上腺轴(HPA轴)终端分泌的关键激素，是评估机体应激状态与内分泌功能的重要生物标志物。近年来，唾液皮质醇检测技术因其无创、便捷、能直接反映生物活性游离激素水平等优势，逐渐成为临床与科研中评估HPA轴功能的“黄金标准”。本文系统综述了唾液皮质醇的生理基础、采集与预处理方法、检测技术的研究进展及其面临的挑战。在检测技术方面，免疫学方法(如ELISA、LFIA、CLIA)和液相色谱–串联质谱法(LC-MS/MS)已广泛应用于实践，而微流控芯片、电化学生物传感器等新兴技术也展现出高灵敏度与即时检测潜力。然而，唾液皮质醇检测仍受多种因素影响，包括昼夜节律、年龄、性别、应激状态及外源性干扰等。未来研究需致力于提高检测技术的灵敏度与特异性，推动便携式即时检测设备的发展，并建立标准化的操作流程与临床参考范围，以促进其在健康监测与疾病诊断中的广泛应用。

Abstract: As a key end-product of the hypothalamic-pituitary–adrenal (HPA) axis, salivary cortisol serves as a crucial biomarker for assessing stress status and endocrine function. In recent years, salivary cortisol detection technology has emerged as the “gold standard” for evaluating HPA axis function in clinical and research settings due to its non-invasive nature, convenience and ability to directly reflect free hormone levels. This article provides a systematic review of the physiological basis of salivary cortisol, its collection and pre-analytical processing methods, research and development in detection technologies, and the associated challenges. In terms of detection techniques, immunological methods such as ELISA, LFIA and CLIA, as well as liquid chromatography-tandem mass spectrometry (LC-MS/MS), have been widely adopted in practice. Meanwhile, emerging technologies such as microfluidic chips and electrochemical biosensors demonstrate high sensitivity and potential for point-of-care testing. However, salivary cortisol measurement is still influenced by various factors, including circadian rhythms, age, gender, stress status and exogenous interferences. Future research should focus on enhancing the sensitivity and specificity of detection technologies, advancing the development of portable, point-of-care testing devices and establishing standardized operational procedures and clinical reference ranges to facilitate their widespread application in health monitoring and disease diagnosis.