Takakura K, Taii S, Ihara Y, Takai I, Mori T
Department of Gynecology and Obstetrics, Kyoto University Faculty of Medicine, Japan.
Endocrinol Jpn. 1989 Apr;36(2):261-8. doi: 10.1507/endocrj1954.36.261.
Ten clomiphene-resistant, normoprolactinemic women with polycystic ovary syndrome (PCOS) were treated by continuous and increasing administration of bromocriptine (Brc), and changes in hormonal profiles as well as therapeutic efficacy were examined. Ovulation was restored in four patients (responders), and two of them became pregnant, whereas the other six patients did not ovulate with Brc alone (non-responders). Endocrine analyses revealed distinct differences between responders and non-responders: 1) pretreatment serum levels of dehydroepiandrosterone sulfate (DHAS) in non-responders were significantly higher than those in responders: 2) exaggerated LH secretion was definitely aggravated with Brc therapy in non-responders, but unchanged or slightly reduced in responders: 3) basal PRL secretions showed a marked reduction in both groups, whereas this response to TRH in responders decreased more markedly than in non-responders with the therapy. It is concluded that low DHAS group patients of PCOS are likely to respond to Brc, whereas high DHAS group patients appear contraindicated for this treatment due to its aggravating effect on LH secretion.
对10名患有多囊卵巢综合征（PCOS）且对克罗米芬耐药、催乳素水平正常的女性，采用持续递增剂量的溴隐亭（Brc）进行治疗，并检测激素水平变化及治疗效果。4名患者（有反应者）恢复排卵，其中2名怀孕，而其他6名患者单独使用Brc时未排卵（无反应者）。内分泌分析显示有反应者和无反应者之间存在明显差异：1）无反应者治疗前血清硫酸脱氢表雄酮（DHAS）水平显著高于有反应者；2）无反应者经Brc治疗后促黄体生成素（LH）分泌过度的情况明显加重，而有反应者则无变化或略有降低；3）两组基础催乳素（PRL）分泌均显著减少，但治疗后有反应者对促甲状腺激素释放激素（TRH）的反应比无反应者下降更明显。结论是，PCOS患者中低DHAS组可能对Brc有反应，而高DHAS组患者因对LH分泌有加重作用，似乎不宜采用此治疗方法。
