Strebel P M, Zacur H A, Gold E B
Obstet Gynecol. 1986 Aug;68(2):195-9.
The present study was undertaken to investigate whether headache in women with nonpuerperal hyperprolactinemia was related to elevated serum prolactin (PRL) levels or the presence of a PRL-secreting pituitary adenoma. The subjects were 469 women seen initially during the period of 1973 to 1979 at four clinical centers with the complaints of secondary amenorrhea and/or galactorrhea, 212 of whom were subsequently diagnosed as having a prolactinoma. Headaches were four times more frequent (relative odds = 3.92; 95% confidence interval = 1.54 to 9.97) in the presence of an adenoma than in its absence. This effect was not altered by adjustment for PRL level or study center, nor could it be explained by confounding due to age, occupation, level of education, use of oral contraceptives, cigarette smoking, ethnic group, or history of head injury. Hyperprolactinemia was associated with headache only if a prolactinoma was present (chi 2 = 9.524; P = .002) and not in the absence of a prolactinoma (chi 2 = 1.547; P = .214). These findings suggest that the space-occupying mass effect of a prolactinoma is responsible for headache in women with nonpuerperal hyperprolactinemia. Despite its nonspecific nature, headache may be a useful indicator of the presence of an occult prolactinoma in women with secondary amenorrhea and/or galactorrhea.
本研究旨在调查非产褥期高催乳素血症女性的头痛是否与血清催乳素（PRL）水平升高或分泌PRL的垂体腺瘤的存在有关。研究对象为1973年至1979年期间在四个临床中心初诊的469名女性，她们主诉有继发性闭经和/或溢乳，其中212名随后被诊断为患有催乳素瘤。存在腺瘤时头痛的发生率是不存在腺瘤时的四倍（相对比值 = 3.92；95%置信区间 = 1.54至9.97）。调整PRL水平或研究中心后，这种效应并未改变，也不能用年龄、职业、教育程度、口服避孕药的使用、吸烟、种族或头部受伤史等混杂因素来解释。仅当存在催乳素瘤时，高催乳素血症才与头痛相关（χ² = 9.524；P = 0.002），而在不存在催乳素瘤时则不相关（χ² = 1.547；P = 0.214）。这些发现表明，催乳素瘤的占位效应是导致非产褥期高催乳素血症女性头痛的原因。尽管头痛具有非特异性，但它可能是继发性闭经和/或溢乳女性隐匿性催乳素瘤存在的有用指标。
