Barnes R B, Mileikowsky G N, Cha K Y, Spencer C A, Lobo R A
J Clin Endocrinol Metab. 1986 Aug;63(2):506-9. doi: 10.1210/jcem-63-2-506.
A relative deficiency in dopamine has been suggested to explain the inappropriate gonadotropin secretion and postulated increased GnRH secretion characteristic of polycystic ovary syndrome (PCO). Previous studies demonstrated an exaggerated decrement in serum LH after large iv doses of dopamine (DA, 4-5 micrograms/kg X min). Normoprolactinemic patients with PCO and weight- and estrogen-matched normal women received iv infusions of DA in two doses (0.5 and 4 micrograms/kg X min). After DA, each subject also received iv metoclopramide (MCP; 10 mg). Serum LH decreased (P less than 0.05) during DA infusion to a similar degree in PCO [23 +/- 3% (+/- SE)] and normal women (20 +/- 2%). In PCO patients, the decrease in LH was similar with both DA doses. Serum PRL and TSH responses to DA were also similar in PCO and normal women. After MCP treatment, serum LH did not change, but serum PRL increased more in PCO (801 +/- 100%) than in normal women (467 +/- 73%; P less than 0.05), as did serum TSH. These data suggest that the sensitivity of LH to DA in patients with PCO is not increased. Further, increased responses of PRL and TSH to MCP may reflect increased dopaminergic activity or, in the case of PRL, the influence of chronic hyperestrogenism.
多巴胺相对缺乏被认为可解释多囊卵巢综合征（PCO）中促性腺激素分泌异常及推测的促性腺激素释放激素（GnRH）分泌增加的特征。既往研究表明，静脉大剂量注射多巴胺（DA，4 - 5微克/千克×分钟）后，血清促黄体生成素（LH）下降幅度增大。PCO且催乳素正常的患者以及体重和雌激素匹配的正常女性接受了两种剂量（0.5和4微克/千克×分钟）的多巴胺静脉输注。注射多巴胺后，每位受试者还接受了静脉注射甲氧氯普胺（MCP；10毫克）。在多巴胺输注期间，PCO患者（23±3%[±标准误]）和正常女性（20±2%）的血清LH均下降（P<0.05），且下降程度相似。在PCO患者中，两种多巴胺剂量下LH的下降情况相似。PCO患者和正常女性对多巴胺的血清催乳素（PRL）和促甲状腺激素（TSH）反应也相似。甲氧氯普胺治疗后，血清LH未改变，但PCO患者的血清PRL升高幅度（801±100%）大于正常女性（467±73%；P<0.05），血清TSH也是如此。这些数据表明，PCO患者LH对多巴胺的敏感性并未增加。此外，PRL和TSH对甲氧氯普胺反应的增加可能反映了多巴胺能活性增加，或者就PRL而言，反映了慢性高雌激素血症的影响。
