Celani M F, Giambuzzi G, Simoni M, Montanini V
Cattedra di Endocrinologia, Università di Modena, Italy.
J Endocrinol Invest. 1987 Aug;10(4):421-5. doi: 10.1007/BF03348162.
Basal prolactin (PRL) levels and PRL responsiveness to thyrotropin-releasing hormone (TRH) were studied in 10 women with primary empty sella (PES) syndrome (mean age 38.2 yr). Hyperprolactinemia (34 to 72 ng/ml) was found in 5 patients (hyperprolactinemic PES, H-PES), whereas 5 patients showed normal (9.5 to 19 ng/ml) PRL levels (normoprolactinemic PES, N-PES). The results were compared with those obtained in 10 healthy women (mean age 32.8 yr, PRL = 7 to 15 ng/ml) and in 8 women with a PRL-secreting pituitary microadenoma (MA) (mean age 37.5 yr, PRL = 39 to 85 ng/ml). The mean basal levels of PRL were significantly higher in patients with H-PES (50.8 +/- 13.2 ng/ml) or MA (64.0 +/- 18.3 ng/ml) than in the control group (10.9 +/- 2.6 ng/ml, p less than 0.02) and in the patients with N-PES (13.9 +/- 3.7 ng/ml, p less than 0.02). In contrast, the relative maximum response (RMR) of PRL to TRH (peak PRL/basal PRL) was significantly lower in the patients with PES (both H-PES and N-PES) or MA (1.4 +/- 0.4, 2.3 +/- 0.7 and 1.2 +/- 0.2, respectively) than in the control subjects (3.6 +/- 1.1; p less than 0.02, less than 0.05 and less than 0.02, respectively). Our results show that the pituitary responsiveness to the acute stimulation with TRH is significantly decreased both in patients with a PRL-secreting pituitary MA and in those with PES. Therefore, the clinical value of the TRH test in distinguishing the PES syndromes from prolactinomas seems to be questionable.
对10例原发性空蝶鞍（PES）综合征女性患者（平均年龄38.2岁）的基础催乳素（PRL）水平及PRL对促甲状腺激素释放激素（TRH）的反应性进行了研究。5例患者（高催乳素血症性PES，H-PES）出现高催乳素血症（34至72 ng/ml），而5例患者的PRL水平正常（9.5至19 ng/ml）（正常催乳素血症性PES，N-PES）。将结果与10例健康女性（平均年龄32.8岁，PRL = 7至15 ng/ml）及8例分泌PRL的垂体微腺瘤（MA）女性患者（平均年龄37.5岁，PRL = 39至85 ng/ml）的结果进行比较。H-PES患者（50.8±13.2 ng/ml）或MA患者（64.0±18.3 ng/ml）的PRL基础平均水平显著高于对照组（10.9±2.6 ng/ml，p<0.02）及N-PES患者（13.9±3.7 ng/ml，p<0.02）。相反，PES患者（H-PES和N-PES）或MA患者的PRL对TRH的相对最大反应（RMR）（峰值PRL/基础PRL）显著低于对照组（分别为1.4±0.4、2.3±0.7和1.2±0.2，对照组为3.6±1.1；p分别<0.02、<0.05和<0.02）。我们的结果表明，分泌PRL的垂体MA患者及PES患者对TRH急性刺激的垂体反应性均显著降低。因此，TRH试验在区分PES综合征与催乳素瘤方面的临床价值似乎值得怀疑。
