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[麦角苄酯治疗高催乳素血症——5例患者的经验]

[Terguride in hyperprolactinemia--experiences with 5 patients].

作者信息

Wüster C, Scholz A, Schmelzle A, Horowski R, Ziegler R

机构信息

Abteilung Innere Medizin, Medizinische Klinik, Heidelberg.

出版信息

Klin Wochenschr. 1990 Apr 2;68(7):384-7. doi: 10.1007/BF01650889.

Abstract

Hyperprolactinemia can successfully be treated by dopaminagonists such as bromocriptin or lisuride. About 10% of patients complain about side effects like orthostatic hypotension, nausea or vomiting, which may lead to discontinuation of treatment. We therefore conducted a study using terguride--a new dopaminagonist--in 5 patients with hyperprolactinemia and intolerable side effects under conventional treatment. Terguride is the transdihydroderivative of lisuride (Dopergin). We treated 5 patients, 2 men with macroprolactinoma and 3 women with microprolactinoma with terguride. The mean duration of treatment was 15.6 months (7-37 months). Patients were treated with up to 5 mg terguride daily. All 5 patients had a marked initial decrease of elevated prolactin levels 8 h after administration of 0.25 mg terguride orally. Three patients became normoprolactinemic after sufficient increase of the dose of terguride, 2 female patients with a microprolactinoma got eumenorrhoeic thereafter. The treatment with terguride was tolerated without side effects by all patients. There were no significant changes of the examined parameters of clinical chemistry nor the other pituitary hormones. Results of cranial computertomography did not change in 4 patients, one patient had tumor progression. Tergurid as a dopaminagonist is an effective inhibitor of prolactin with little side effects and thus a useful drug in the treatment of hyperprolactinemia.

摘要

高催乳素血症可用溴隐亭或利舒脲等多巴胺激动剂成功治疗。约10%的患者抱怨有体位性低血压、恶心或呕吐等副作用,这可能导致治疗中断。因此,我们对5例高催乳素血症且在传统治疗下出现难以耐受副作用的患者使用了一种新的多巴胺激动剂——替古瑞肽进行研究。替古瑞肽是利舒脲(多培那明)的反式二氢衍生物。我们用替古瑞肽治疗了5例患者,其中2例患有大催乳素瘤的男性和3例患有微催乳素瘤的女性。平均治疗时长为15.6个月(7 - 37个月)。患者每日使用替古瑞肽的剂量最高达5毫克。所有5例患者在口服0.25毫克替古瑞肽8小时后,升高的催乳素水平均有明显的初始下降。在充分增加替古瑞肽剂量后,3例患者催乳素水平恢复正常,2例患有微催乳素瘤的女性患者随后月经恢复正常。所有患者对替古瑞肽治疗耐受且无副作用。临床化学检查参数及其他垂体激素均无显著变化。4例患者的头颅计算机断层扫描结果未改变,1例患者出现肿瘤进展。替古瑞肽作为一种多巴胺激动剂,是一种有效的催乳素抑制剂,副作用小,因此是治疗高催乳素血症的一种有用药物。

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