Diedrich K, Leidenberger F, Lehmann F, Bettendorf G
Geburtshilfe Frauenheilkd. 1978 Sep;38(9):716-25.
Among 62 patients with galactorrhoea a corpus luteum deficiency or anovulatory cycles were found in 35 cases by serum progesterone determination, endometrial biopsy or basal body temperature records. 27 patients had a hyperpro-lactenemic amenorrhoea-galactorrhoea syndrome. During treatment with 2.5-5 mg. of Pravidel daily the basal body temperature was recorded, the concentrations of serum FSH, LH, Prolactin and progesterone were determined by radioimmunoassay. Other possible reasons for infertility were investigated. 10 of the 19 patients with normal serum prolactins in the group with deficient corpus luteum or anovulation became pregnant after a short duration of treatment, whereas only 2 of the 16 patients with hyperprolactenemia became pregnant. Among 27 patients with secondary amenorrhoea 11 became pregnant. All these patients had increased serum prolactins. During treatment with Pravidel all patients showed a significant increase of FSH and LH concentrations and a decrease of the prolactin concentrations. The outcome of the pregnancy of the 58 patients who became pregnant during treatment with Pravidel was also reported. 14 of the 58 pregnancies occured following additional treatment with Dyneric or HMG/HCG. Up to now there were 18 term deliveries following uneventful pregnancies. There were no fetal anomalies. The abortion rate was not higher than in the general population. All results show that euprolactinemia is not alone characterized by normal prolactin concentration. The clinical signs and symptoms of galactorrhoea without increase of prolactin over 20 ng/ml. in conjunction with ovarian dysfunction must be classified as dysprolactinemia.
在62例溢乳患者中,通过血清孕酮测定、子宫内膜活检或基础体温记录发现35例存在黄体功能不足或无排卵周期。27例患者患有高催乳素血症性闭经 - 溢乳综合征。在每日使用2.5 - 5毫克溴隐亭治疗期间,记录基础体温,通过放射免疫测定法测定血清促卵泡生成素(FSH)、促黄体生成素(LH)、催乳素和孕酮的浓度。对其他可能的不孕原因进行了调查。在黄体功能不足或无排卵组中,19例血清催乳素正常的患者中有10例在短时间治疗后怀孕,而16例高催乳素血症患者中只有2例怀孕。在27例继发性闭经患者中,11例怀孕。所有这些患者的血清催乳素均升高。在使用溴隐亭治疗期间,所有患者的FSH和LH浓度均显著升高,催乳素浓度降低。还报告了在使用溴隐亭治疗期间怀孕的58例患者的妊娠结局。58例妊娠中有14例是在加用克罗米芬或人绝经期促性腺激素/人绒毛膜促性腺激素后发生的。到目前为止,有18例妊娠顺利足月分娩。未发现胎儿异常。流产率不高于一般人群。所有结果表明,正常催乳素血症并非仅以催乳素浓度正常为特征。催乳素不超过20纳克/毫升且伴有卵巢功能障碍的溢乳临床体征和症状必须归类为催乳素分泌异常血症。