Kapcala L P, Lakshmanan M C
Department of Medicine, Case Western University School of Medicine, Cleveland Metropolitan General Hospital.
J Endocrinol Invest. 1989 Dec;12(11):815-21. doi: 10.1007/BF03350070.
Although galactorrhea and/or enhanced prolactin (PRL) secretion have been reported with a variety of thoracic stimuli, the effect of thoracic stimulation on dynamic prolactin secretion is not clear. A 49-year-old woman with ventilatory muscle weakness from polio presented with galactorrhea, and intermittent hyperprolactinemia but regular menses. The galactorrhea was noted following the use of a new, tight fitting cuirass (thoracic apparatus which assists ventilation). To determine if the new, "tight" cuirass elicited enhanced PRL secretion, and to assess more extensively the effect of such thoracic stimulation on PRL secretion, serum PRL was measured during brief and prolonged stimulation, sleep, and pharmacological manipulation of PRL. Basal PRL was normal (less than 25 ng/ml) and increased during brief stimulation (1 hour) with the "tight" (137%) and "loose" cuirass (140%). Although the absolute increments were similar, the "tight" cuirass elicited an earlier PRL peak than the "loose" cuirass and the PRL began to decrease while the "tight" cuirass was still functioning. Several hours of thoracic stimulation resulted in a transient rise in PRL and a fall to normal, prestimulatory levels despite persistent stimulation. During this stimulation, PRL did not rise after sleep nor after insulin-induced hypoglycemia despite normal cortisol and GH increments, but the PRL response after TRH was exaggerated.(ABSTRACT TRUNCATED AT 250 WORDS)
尽管已有报道多种胸部刺激可导致溢乳和/或催乳素(PRL)分泌增加,但胸部刺激对动态催乳素分泌的影响尚不清楚。一名49岁患有小儿麻痹后遗症致通气肌无力的女性出现溢乳、间歇性高催乳素血症但月经规律。溢乳是在使用一种新的、紧身的胸甲(辅助通气的胸部装置)后出现的。为了确定这种新的“紧身”胸甲是否会引起PRL分泌增加,并更广泛地评估这种胸部刺激对PRL分泌的影响,在短暂和长时间刺激、睡眠以及PRL的药物处理过程中测量了血清PRL。基础PRL正常(低于25 ng/ml),在使用“紧身”胸甲(升高137%)和“宽松”胸甲(升高140%)进行短暂刺激(1小时)期间升高。虽然绝对升高幅度相似,但“紧身”胸甲比“宽松”胸甲引起的PRL峰值出现得更早,并且在“紧身”胸甲仍在起作用时PRL就开始下降。数小时的胸部刺激导致PRL短暂升高,尽管持续刺激但仍降至刺激前的正常水平。在此刺激期间,尽管皮质醇和生长激素正常升高,但睡眠后或胰岛素诱导的低血糖后PRL并未升高,但促甲状腺激素释放激素(TRH)刺激后的PRL反应增强。(摘要截短于250字)