Roelfsema F, Frölich M, de Boer H
Department of Endocrinology, University Hospital, Leiden, The Netherlands.
Clin Endocrinol (Oxf). 1989 Oct;31(4):439-51. doi: 10.1111/j.1365-2265.1989.tb01268.x.
The 24-h PRL and LH hormone profiles were analysed of 16 cured male acromegalic patients who had undergone selective transsphenoidal surgery 4-9 years previously. Eight of these patients also underwent pituitary irradiation. Blood samples were taken at 20-min intervals; the PRL and LH data were analysed with the cluster program. ARIMA modelling, cross-correlation techniques, Fourier analysis, and cosinor analysis. About 10-11 PRL and LH peaks were demonstrated for both non-irradiated and irradiated patients. The absolute heights of PRL pulses and the mean valley levels were significantly greater for irradiated patients than for non-irradiated patients, but the increment in amplitude did not differ. A significant diurnal rhythm for PRL was found for all non-irradiated patients but for only one irradiated patient. LH pulse area and amplitude were lower in the group of irradiated patients. The incremental responses of LH and PRL to GnRH and TRH, respectively, were lower in irradiated patients than in non-irradiated patients. During the night (0200-0800 h) the number of PRL pulses decreased in non-irradiated patients but not in irradiated patients. Pulse nadirs and amplitudes increased during the evening and night in non-irradiated patients but were constant in irradiated subjects. Bivariate modelling of the data for 14 patients revealed significant cross-correlations between LH and PRL pulses in nine subjects. This study demonstrates that the pulsatile secretion of PRL and LH in treated acromegalics is basically normal. Additional radiation therapy, however, may lead to damage of the hypothalamus, as reflected by the absence of a circadian PRL rhythm. A direct influence on the pituitary by radiation is indicated by the decreased magnitude of LH pulses and the diminished response of LH and PRL after injection of GnRH and TRH, respectively.
对16例已治愈的男性肢端肥大症患者的24小时催乳素（PRL）和促黄体生成素（LH）激素谱进行了分析，这些患者在4至9年前接受了选择性经蝶窦手术。其中8例患者还接受了垂体放疗。每隔20分钟采集一次血样；使用聚类程序、自回归积分滑动平均（ARIMA）建模、互相关技术、傅里叶分析和余弦分析对PRL和LH数据进行分析。未接受放疗和接受放疗的患者均显示出约10 - 11个PRL和LH峰值。接受放疗患者的PRL脉冲绝对高度和平均谷值水平显著高于未接受放疗的患者，但振幅增量无差异。所有未接受放疗的患者均发现PRL有显著的昼夜节律，而接受放疗的患者中只有1例有此节律。接受放疗患者组的LH脉冲面积和振幅较低。接受放疗患者的LH和PRL对促性腺激素释放激素（GnRH）和促甲状腺激素释放激素（TRH）的增量反应分别低于未接受放疗的患者。在夜间（02:00 - 08:00），未接受放疗的患者PRL脉冲数量减少，而接受放疗的患者则未减少。未接受放疗的患者在傍晚和夜间脉冲最低点和振幅增加，而接受放疗的患者则保持恒定。对14例患者的数据进行双变量建模显示，9例患者的LH和PRL脉冲之间存在显著的互相关。本研究表明，治疗后的肢端肥大症患者PRL和LH的脉冲式分泌基本正常。然而，额外的放射治疗可能会导致下丘脑损伤，这表现为PRL昼夜节律消失。LH脉冲幅度降低以及注射GnRH和TRH后LH和PRL反应减弱分别表明放疗对垂体有直接影响。
