Lengyel A M, Vieira J G, Chacra A R, Abucham-Filho J Z, Lima M P, Ribeiro A B, Ramos O L
J Clin Endocrinol Metab. 1982 Apr;54(4):849-53. doi: 10.1210/jcem-54-4-849.
Hyperprolactinemia has previously been noted in patients with essential hypertension and it has been suggested that the increased PRL levels in this condition may reflect reduced central dopaminergic activity. In the present study, PRL secretion was evaluated in 17 patients with essential hypertension and in 9 normal controls as an indirect index of hypothalamic-pituitary dopaminergic activity. PRL levels were measured basally, at night, and after TRH (200 micrograms, iv), metoclopramide (10 mg, orally), and L-dopa (500 mg, orally). Basal PRL levels were similar in both groups [essential hypertension, 301.2 +/- 176.2 microunits/ml; controls, 334.2 +/- 98.8 microunits/ml (mean +/- SD)]. No differences in PRL levels were found after TRH, L-dopa, and metoclopramide or during sleep between the 2 groups. When the patients were classified according to their PRA, no differences were noticed in either basal levels or the patterns of PRL response. It is concluded that PRL secretion is normal in patients with essential hypertension, which could be indirect evidence against reduced hypothalamic-pituitary dopaminergic activity in this disease. However, minor abnormalities not detected by PRL measurements could be involved in the pathogenesis of essential hypertension.
高催乳素血症此前在原发性高血压患者中已有报道，有人认为这种情况下催乳素水平升高可能反映中枢多巴胺能活性降低。在本研究中，对17例原发性高血压患者和9名正常对照者的催乳素分泌进行了评估，以此作为下丘脑 - 垂体多巴胺能活性的间接指标。分别在基础状态、夜间以及注射促甲状腺激素释放激素（TRH，200微克，静脉注射）、胃复安（10毫克，口服）和左旋多巴（500毫克，口服）后测定催乳素水平。两组的基础催乳素水平相似[原发性高血压组，301.2±176.2微单位/毫升；对照组，334.2±98.8微单位/毫升（均值±标准差）]。两组在注射TRH、左旋多巴和胃复安后或睡眠期间的催乳素水平均无差异。根据患者的血浆肾素活性（PRA）进行分类时，基础水平或催乳素反应模式均未发现差异。得出的结论是，原发性高血压患者的催乳素分泌正常，这可能是该疾病下丘脑 - 垂体多巴胺能活性未降低的间接证据。然而，催乳素测量未检测到的轻微异常可能参与原发性高血压的发病机制。
