Prescott R W, Johnston D G, Kendall-Taylor P, Crombie A, Hall K, McGregor A, Hall R
Lancet. 1982 Jan 30;1(8266):245-8. doi: 10.1016/s0140-6736(82)90975-8.
Men with hyperprolactinaemia present with large tumours. Conventional therapy with surgery and/or irradiation is unsatisfactory, with up to 100% of patients remaining hyperprolactinaemic (or subsequently developing pituitary insufficiency). In view of reports of bromocriptine-induced regression of prolactinomas, eight consecutive male hyperprolactinaemic patients with impotence and/or symptoms related to local tumour effects were treated with bromocriptine 20 mg daily as sole therapy for 3-11 months. Symptoms were relieved partly or completely in seven patients and serum prolactin was restored to normal or near normal in all men. Serum thyroxine and plasma cortisol response to hypoglycaemia became normal in two men who had subnormal values before therapy. Mean serum growth hormone response to hypoglycaemia rose significantly as did plasma testosterone concentrations. Evidence of tumour regression, sometimes massive, was seen in the six patients who underwent repeat radiology. The symptomatic relief and biochemical and radiological improvement in these patients indicate that bromocriptine therapy may now be the treatment of choice for hyperprolactinaemic men with large tumours.
患有高泌乳素血症的男性患者多表现为大肿瘤。采用手术和/或放疗的传统治疗方法并不理想，高达100%的患者仍存在高泌乳素血症（或随后出现垂体功能不全）。鉴于有报道称溴隐亭可使泌乳素瘤消退，对8例连续的患有高泌乳素血症且伴有阳痿和/或与局部肿瘤效应相关症状的男性患者，采用每日20毫克溴隐亭作为唯一治疗方法，治疗3至11个月。7例患者的症状部分或完全缓解，所有男性患者的血清泌乳素恢复至正常或接近正常水平。在治疗前值低于正常的2名男性患者中，血清甲状腺素和血浆皮质醇对低血糖的反应恢复正常。平均血清生长激素对低血糖的反应显著升高，血浆睾酮浓度也显著升高。在接受重复放射检查的6例患者中，可见肿瘤消退的证据，有时肿瘤消退明显。这些患者的症状缓解以及生化和放射学改善表明，溴隐亭治疗现在可能是患有大肿瘤的高泌乳素血症男性患者的首选治疗方法。
