March C M, Mishell D R, Kletzky O A, Israel R, Davajan V, Nakamura R M
Am J Obstet Gynecol. 1979 May 1;134(1):45-8. doi: 10.1016/0002-9378(79)90794-4.
One hundred sixty-seven women with secondary amenorrhea were observed from six months to four years. In 66 patients, the amenorrhea followed the discontinuation of oral contraceptives (postpill) while in the remaining 101 the amenorrhea was not temporally pill related (non-postpill). Galactorrhea was present in 43 (65%) of those with postpill amenorrhea and in 32 (32%) of those with non-postpill amenorrhea (p less than 0.001). Tomography of the sella turcica was performed in the 75 women with galactorrhea and in the 35 without galactorrhea who did not have withdrawal uterine bleeding following progesterone administration and who had low or normal serum follicle-stimulating hormone levels (hypothalamic-pituitary failure). Forty of the 75 patients with amenorrhea and galactorrhea had radiographic evidence of a pituitary tumor whereas only eight of 35 patients with hypothalamic-pituitary failure without galactorrhea had an abnormal sella turcica (p less than 0.01). The incidence of radiographic abnormalities in those with galactorrhea was similar in both the postpill and non-postpill groups.
对167名继发性闭经的女性进行了6个月至4年的观察。66例患者的闭经发生在停用口服避孕药后(停药后闭经),其余101例患者的闭经与服用避孕药无时间关联(非停药后闭经)。停药后闭经患者中有43例(65%)出现溢乳,非停药后闭经患者中有32例(32%)出现溢乳(p<0.001)。对75例有溢乳的女性以及35例无溢乳、孕激素给药后无撤药性子宫出血且血清促卵泡激素水平低或正常(下丘脑-垂体功能衰竭)的女性进行了蝶鞍断层扫描。75例闭经伴溢乳患者中有40例有垂体瘤的影像学证据,而35例无溢乳的下丘脑-垂体功能衰竭患者中只有8例蝶鞍异常(p<0.01)。溢乳患者中影像学异常的发生率在停药后闭经组和非停药后闭经组中相似。