Blackwell R E, Boots L R, Goldenberg R L, Younger J B
Fertil Steril. 1979 Aug;32(2):177-82.
Twelve women with galactorrhea-amenorrhea and prolactin levels greater than 100 ng/ml were evaluated with dynamic pituitary challenge testing. Forty-two per cent of the patients had positive findings on polytomography and subsequent surgical confirmation of a pituitary tumor. Patients with tumors had a delayed elevation of growth hormone (GH) and cortisol following induction of insulin hypoglycemia. Patients had increased thyroid-stimulating hormone levels after injection of thyrotropin-releasing factor, but showed blunting of prolactin secretion. Patients with tumors had decreased basal levels of GH and showed a blunted response to luteinizing hormone-releasing hormone (LRF) stimulation. These patients had normal elevations of follicle-stimulating hormone after LRF challenge. Patients with tumors showed a delay in elevation of GH levels following l-dopa treatment. They also failed to show prolactin suppression following this treatment. There are consistently predictive changes that occur in pituitary functions in the presence of a pituitary tumor. However, absolute prolactin levels and sellar polytomography are more reliable in diagnosing the presence of a pituitary tumor in the patient with galactorrhea-amenorrhea.
对12名患有溢乳-闭经且催乳素水平高于100 ng/ml的女性进行了垂体动态激发试验评估。42%的患者在体层摄影检查中有阳性发现，随后经手术证实患有垂体瘤。患有垂体瘤的患者在胰岛素低血糖诱导后生长激素（GH）和皮质醇升高延迟。患者在注射促甲状腺激素释放因子后促甲状腺激素水平升高，但催乳素分泌反应迟钝。患有垂体瘤的患者基础GH水平降低，对促黄体生成素释放激素（LRF）刺激反应迟钝。这些患者在LRF激发后促卵泡激素正常升高。患有垂体瘤的患者在左旋多巴治疗后GH水平升高延迟。他们在该治疗后也未出现催乳素抑制。垂体瘤存在时垂体功能会持续出现可预测的变化。然而，对于溢乳-闭经患者，绝对催乳素水平和蝶鞍体层摄影在诊断垂体瘤方面更可靠。
