Tolis G, Goldstein M, Friesen H G
J Clin Invest. 1973 Apr;52(4):783-8. doi: 10.1172/JCI107241.
Prolactin secretion was assessed in 23 patients with hypothalamic-pituitary disorders using L-Dopa suppression, chlorpromazine (CPZ), and thyrotropin-releasing hormone (TRH) stimulation tests. Based on the responses to these tests, three groups of patients were identified: those with panhypopituitarism (group I) and those with partial hypopituitarism either with (group II) or without (group III) evidence of hypothalamic involvement. Panhypopituitary patients (group I) consistently had low serum prolactin values and failed to respond to all tests. Patients with hypothalamic involvement (group II) exhibited (a) elevated basal prolactin values. (b) an increase in serum prolactin after TRH stimulation. (c) blunted response to L-Dopa, and (d) lack of response to chlorpromazine stimulation. Patients with partial hypopituitarism but without hypothalamic involvement (group III) had normal serum prolactin levels and suppressed normally after L-Dopa; although the magnitude of response to both stimulatory agents was significantly lower than normally found the ratio of prolactin levels post-CPZ and TRH (Delta prolactin CPZ/Delta prolactin TRH) was similar to the ratio of normal individuals suggesting that these patients (group III) had a normal hypothalamic-pituitary prolactin axis. In the 23 patients studied, the most consistent disorder of pituitary function proved to be an abnormal response to one or other of the three tests employed for the evaluation of prolactin secretion. Hence these tests have considerable potential as a sensitive screening procedure in the evaluation of patients suspected of having hypothalamic-pituitary disease.
采用左旋多巴抑制试验、氯丙嗪（CPZ）试验及促甲状腺激素释放激素（TRH）刺激试验，对23例下丘脑 - 垂体疾病患者的催乳素分泌情况进行了评估。根据这些试验的结果，将患者分为三组：全垂体功能减退患者（I组）、有下丘脑受累证据的部分垂体功能减退患者（II组）和无下丘脑受累证据的部分垂体功能减退患者（III组）。全垂体功能减退患者（I组）血清催乳素值持续偏低，对所有试验均无反应。有下丘脑受累的患者（II组）表现为：（a）基础催乳素值升高；（b）TRH刺激后血清催乳素升高；（c）对左旋多巴反应减弱；（d）对氯丙嗪刺激无反应。部分垂体功能减退但无下丘脑受累的患者（III组）血清催乳素水平正常，左旋多巴刺激后能正常被抑制；尽管对两种刺激剂的反应幅度均显著低于正常情况，但CPZ和TRH刺激后催乳素水平的比值（Δ催乳素CPZ/Δ催乳素TRH）与正常个体相似，提示这些患者（III组）下丘脑 - 垂体催乳素轴正常。在所研究的23例患者中，垂体功能最一致的紊乱表现为对评估催乳素分泌所采用的三项试验中的一项或多项反应异常。因此，这些试验作为一种敏感的筛查方法，在评估疑似下丘脑 - 垂体疾病的患者时具有相当大的潜力。
