Gross D J, Halperin Y, Gomori J M, Glaser B
Department of Endocrinology and Metabolism, Hebrew University-Hadassah Medical School, Hadassah University Hospital, Jerusalem, Israel.
Isr J Med Sci. 1989 May;25(5):256-60.
The effect of long-term, high-dose therapy with bromocriptine (BR) on the clinical and hormonal response, tumor size and neuro-ophthalmological status was studied in seven acromegalic patients. The mean BR dose was 64 mg/day (range 35 to 80) for a mean period of 11 months (range 10 to 12). In six patients there was a clinical improvement already manifest at low BR doses (10 to 20 mg). Serum growth hormone levels fell substantially (greater than 50%) in five patients, and the growth hormone response to thyrotropin-releasing hormone (TRH) and glucose were similar to those previously reported at lower doses of the drug, as were the prolactin and thyroid-stimulating hormone responses to TRH. In three patients, repeat CT scan disclosed a reduction in tumor size. In none of the patients was there evidence of tumor progression, with the possible exception of one patient who developed an impairment of the visual evoked potential response. These results suggest that when compared to previous studies in which lower doses of BR were used, a high BR dose is not superior in terms of clinical response and hormone secretion, but does appear to increase the percentage of patients who respond with a reduction in tumor size.
研究了7例肢端肥大症患者长期大剂量使用溴隐亭（BR）治疗对临床和激素反应、肿瘤大小及神经眼科状况的影响。BR的平均剂量为64毫克/天（范围35至80毫克），平均疗程为11个月（范围10至12个月）。6例患者在低剂量BR（10至20毫克）时就已出现临床改善。5例患者的血清生长激素水平大幅下降（超过50%），生长激素对促甲状腺激素释放激素（TRH）和葡萄糖的反应与之前报道的低剂量该药时相似，催乳素和促甲状腺激素对TRH的反应也是如此。3例患者的重复CT扫描显示肿瘤大小缩小。除1例患者出现视觉诱发电位反应受损外，其他患者均无肿瘤进展的证据。这些结果表明，与之前使用较低剂量BR的研究相比，高剂量BR在临床反应和激素分泌方面并无优势，但似乎确实增加了肿瘤大小缩小的反应患者百分比。
