Pavelka R, Schmid R, Schneider W H, Spona J
Wien Klin Wochenschr. 1979 Dec 7;91(23):793-8.
58 women with raised serum prolactin levels and normal hypophyseal-X-ray parameters were subdivided into three groups according to the serum prolactin level (16 to 40, 41 to 80, greater than 80 ng/ml). In addition to the determination of LH, FSH, oestradiol, progesterone and testosterone in the serum and thyroid diagnostic procedures the following hormonal tests were performed: 1. response to gestagen; 2. response to clomiphene; 3. Gn-RH-test for hypophyseal function; 4. ovarian response to administered gonadotropins (only in cases with prolactin levels greater than 80 ng/ml). The grade of menstrual cycle disorders depends on the severity of the observed hyperprolactinaemia. Slight disorders like luteal phase insufficiency, anovulatory cycle and oligomenorrhoea are associated with low- or medium-grade hyperprolactinaemia. Mainly secondary, but also primary amenorrhoea is found in cases with higher serum prolactin levels (greater than 80 ng/ml). In these cases the hypophyseal response to Gn-RH is frequently found (61%) to be negative and, moreover, the ovarian response to administered gonadotropins seems to be diminished. Increasing HPRL levels often appear to be associated with a negative response to the other above-mentioned tests.
58名血清催乳素水平升高但垂体X线参数正常的女性,根据血清催乳素水平(16至40、41至80、大于80 ng/ml)分为三组。除了测定血清中的促黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇、孕酮和睾酮以及进行甲状腺诊断程序外,还进行了以下激素检测:1. 对孕激素的反应;2. 对克罗米芬的反应;3. 垂体功能的促性腺激素释放激素(Gn-RH)试验;4. 卵巢对给予促性腺激素的反应(仅适用于催乳素水平大于80 ng/ml的病例)。月经周期紊乱的程度取决于所观察到的高催乳素血症的严重程度。轻度紊乱如黄体期不足、无排卵周期和月经过少与低度或中度高催乳素血症有关。血清催乳素水平较高(大于80 ng/ml)的病例中主要发现继发性闭经,但也有原发性闭经。在这些病例中,经常发现垂体对Gn-RH的反应(61%)为阴性,而且卵巢对给予促性腺激素的反应似乎减弱。催乳素水平升高往往似乎与对上述其他检测的阴性反应有关。