Boyd A E, Reichlin S, Turksoy R N
Ann Intern Med. 1977 Aug;87(2):165-75. doi: 10.7326/0003-4819-87-2-165.
Tests of prolactin regulation in the galactorrhea-amenorrhea syndrome were compared in 18 patients with normal pituitary fossae, seven patients with prolactin-secreting adenomas, and eight normal women. Mean basal prolactin was highest in patients with adenomas and was elevated in those with normal fossae when compared with normal subjects (278 versus 73 versus 10.2 ng/ml). Levodopa, water loading, or luteinizing hormone-releasing hormone testing were of no predictive value in the diagnosis of adenoma. Some patients with adenomas show a greater prolactin response after administration of thyrotrophin hormone-releasing hormone (TRH) than of chlorpromazine, whereas these responses are usually similar in patients with normal fossae. A mean basal prolactin level above 150 ng/ml or an increase of more than 100 ng/ml after TRH administration in a patient with hyperprolactinemia unresponsive to chlorpromazine stimulation strongly suggests a prolactin-secreting tumor. However, because some patients with tumor have prolactin levels below 150 ng/ml, or do not respond to TRH stimulation, or both, functional studies alone cannot permit the diagnosis of all adenomas before the appearance of radiographic changes.
对18例垂体窝正常的患者、7例分泌催乳素的腺瘤患者和8名正常女性进行了比较，以研究溢乳-闭经综合征中催乳素调节情况。腺瘤患者的平均基础催乳素水平最高，与正常受试者相比，垂体窝正常的患者的基础催乳素水平也升高（分别为278 ng/ml、73 ng/ml和10.2 ng/ml）。左旋多巴、水负荷试验或促黄体生成素释放激素试验对腺瘤的诊断无预测价值。一些腺瘤患者在给予促甲状腺激素释放激素（TRH）后比给予氯丙嗪后催乳素反应更大，而垂体窝正常的患者中这些反应通常相似。在对氯丙嗪刺激无反应的高催乳素血症患者中，基础催乳素水平平均高于150 ng/ml或给予TRH后升高超过100 ng/ml强烈提示分泌催乳素的肿瘤。然而，由于一些肿瘤患者的催乳素水平低于150 ng/ml，或对TRH刺激无反应，或两者皆有，仅靠功能研究在影像学改变出现之前不能诊断所有腺瘤。
