Sieck J O, Niles N L, Jinkins J R, Al-Mefty O, el-Akkad S, Woodhouse N
Horm Res. 1986;23(3):167-76. doi: 10.1159/000180318.
24 patients with an extrasellar prolactinoma (mean prolactin 4,722 ng/ml), 8 of whom had previously had surgery, received 5-40 mg bromocriptine daily for 13-252 weeks. The mean prolactin level had fallen 89% at 2 days, 95% at 6 weeks, and 15 patients achieved normal values. Tumor shrinkage occurred in all 9 patients rescanned within 2 weeks and later was documented in 23; in 18 the extrasellar tumour disappeared. 12 patients had visual abnormalities; 7, including 2 who had been completely blind, improved within 1 week. 2 patients had normal prolactin levels after withdrawal of bromocriptine, 1 following radiotherapy and the other during two uncomplicated pregnancies. Bromocriptine is safe and effective. We conclude that medical treatment should always precede surgery unless pituitary apoplexy causes sudden deterioration of vision. Most patients will subsequently require radiotherapy or surgery for permanent cure.
24例鞍外催乳素瘤患者（催乳素平均水平为4722 ng/ml），其中8例曾接受过手术，每天服用5 - 40毫克溴隐亭，持续13 - 252周。服药2天时催乳素平均水平下降了89%，6周时下降了95%，15例患者催乳素水平恢复正常。在2周内再次扫描的所有9例患者均出现肿瘤缩小，之后有记录显示23例患者肿瘤缩小；18例患者的鞍外肿瘤消失。12例患者有视觉异常；7例患者，包括2例曾完全失明的患者，在1周内视力有所改善。2例患者在停用溴隐亭后催乳素水平恢复正常，1例是在放疗后，另1例是在两次正常妊娠期间。溴隐亭安全有效。我们得出结论，除非垂体卒中导致视力突然恶化，否则应始终先进行药物治疗再进行手术。大多数患者随后需要放疗或手术才能实现根治。
