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[正常催乳素血症性溢乳综合征的发病机制与治疗研究]

[A study on pathogenesis and treatment of normoprolactinemic galactorrhea syndrome].

作者信息

Aisaka K, Ando S, Kokubo K, Sasaki S, Sudo I, Toriya Y, Yoshida K, Mori H

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1985 Nov;37(11):2385-92.

PMID:4078422
Abstract

To investigate the pathogenesis of the normoprolactinemic galactorrhea syndrome, the response of prolactin secretion to TRH administration and the circadian profile of serum prolactin levels were examined in 13 women with galactorrhea whose resting levels of serum prolactin were lower than 25 ng/ml. Bromocriptine (5mg/day) was administered for 30 days and the mid-luteal serum estradiol and progesterone levels, as indicators of luteal function, were also measured before and after the administration. The basal levels of serum prolactin in these patients were significantly higher than those of the control (p less than 0.05), and the response of prolactin secretion also increased significantly at 30, 60, 90 and 120 min. after TRH administration compared to those of the control (p less than 0.005). The circadian profile of serum prolactin showed significantly higher levels from 22 to 8 o'clock compared to the control (p less than 0.05 approximately 0.005). And serum prolactin levels of these patients were higher than 25 ng/ml during the nocturnal period. When bromocriptine was administered, serum prolactin levels of these patients dropped conspicuously, and the nocturnal surges of prolactin also suppressed. Serum estradiol and progesterone levels in the mid-luteal phase normalized apparently due to the administration of bromocriptine (p less than 0.005, p less than 0.005), and galactorrhea also disappeared. These facts suggested that the normoprolactinemic galactorrhea syndrome might be caused by transient occulted hyperprolactinemia, and the treatment with bromocriptine was useful not only in suppressing galactorrhea but also in improving the luteal function in these patients.

摘要

为研究正常催乳素血症性溢乳综合征的发病机制,对13例血清催乳素静息水平低于25 ng/ml的溢乳女性患者,检测了催乳素分泌对促甲状腺激素释放激素(TRH)给药的反应以及血清催乳素水平的昼夜变化情况。给予溴隐亭(5mg/天)治疗30天,并在给药前后测量了作为黄体功能指标的黄体中期血清雌二醇和孕酮水平。这些患者的血清催乳素基础水平显著高于对照组(p<0.05),且与对照组相比,TRH给药后30、60、90和120分钟时催乳素分泌反应也显著增加(p<0.005)。血清催乳素的昼夜变化情况显示,与对照组相比,22点至8点的水平显著更高(p约为0.05至0.005)。并且这些患者在夜间血清催乳素水平高于25 ng/ml。给予溴隐亭治疗后,这些患者的血清催乳素水平显著下降,催乳素的夜间高峰也受到抑制。由于给予溴隐亭,黄体中期的血清雌二醇和孕酮水平明显恢复正常(p<0.005,p<0.005),溢乳也消失了。这些事实表明,正常催乳素血症性溢乳综合征可能由短暂隐匿性高催乳素血症引起,溴隐亭治疗不仅对抑制溢乳有用,而且对改善这些患者的黄体功能也有用。

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