Frantz A G, Kleinberg D L
Fed Proc. 1978 Jun;37(8):2192-7.
Studies of prolactin secretion in humans have confirmed the concept, derived originally from animal investigations, that prolactin is predominantly controlled by tonic inhibition from the hypothalamus. The locus of action of dopamine and dopaminergic agents such as the ergot alkaloids inhibiting prolactin secretion appears to be primarily at the pituitary level, though a hypothalamic action to increase secretion of prolactin inhibitory factor may also contribute. Prolactin hypersecretion, through any of several possible mechanisms, is frequently but not always found in patients with galactorrhea. Recent studies have shown that hyperprolactinemia is considerably more common than was previously appreciated among patients without galactorrhea. It is present in at least two-thirds of all patients with pituitary tumors and in a significant minority of patients with secondary amenorrhea. Its clinical measurement in these conditions is therefore of considerable diagnostic importance. Whatever the pathophysiology of its production, hyperprolactinemia of all forms is responsive to treatment with the newer ergot alkaloids. The potential use of these agents for therapeutic purposes, particularly in the treatment of infertility, appears to be wider than was originally anticipated.
对人类催乳素分泌的研究证实了最初源自动物研究的概念，即催乳素主要受下丘脑的紧张性抑制控制。多巴胺和多巴胺能药物（如麦角生物碱）抑制催乳素分泌的作用位点似乎主要在垂体水平，不过下丘脑增加催乳素抑制因子分泌的作用也可能起作用。通过几种可能机制中的任何一种导致的催乳素分泌过多，在溢乳患者中经常但并非总是能发现。最近的研究表明，高催乳素血症在无溢乳的患者中比以前认为的要常见得多。在所有垂体肿瘤患者中至少有三分之二存在高催乳素血症，在继发性闭经患者中也有相当一部分存在。因此，在这些情况下对其进行临床检测具有相当重要的诊断意义。无论其产生的病理生理学如何，所有形式的高催乳素血症对新型麦角生物碱治疗均有反应。这些药物在治疗方面的潜在用途，特别是在治疗不孕症方面，似乎比最初预期的更为广泛。
