Grossman A, Moult P J, McIntyre H, Evans J, Silverstone T, Rees L H, Besser G M
Clin Endocrinol (Oxf). 1982 Oct;17(4):379-88. doi: 10.1111/j.1365-2265.1982.tb01603.x.
Endogenous opiates are involved in the control of pituitary gonadotrophin and PRL secretion, and possibly of food intake. Both hyperprolactinaemia and weight loss (especially in anorexia nervosa) are frequently associated with amenorrhoea and an absence of gonadotrophin pulsatility. Since it has been suggested that increased endogenous opiate tone may operate in both conditions, we infused high-doses of naloxone into twelve patients with amenorrhoea of whom five had hyperprolactinaemia and seven had weight-loss related amenorrhoea. Eleven of the twelve patients had low levels of oestradiol (less than 50 pmol/l). Naloxone induced a marked rise in both LH and FSH levels in all of the five hyperprolactinaemic patients. In contrast, the patients with weight-loss amenorrhoea responded to naloxone with only a small or no rise in gonadotrophins. There was no consistent change in PRL in either group of patients. It is concluded that in hyperprolactinaemia, but not weight-loss amenorrhoea, there is an important endogenous opiate-mediated tonic inhibition of secretion of hypothalamic gonadotrophin releasing hormone.
内源性阿片肽参与垂体促性腺激素和催乳素分泌的调控，可能还参与食物摄入的调控。高催乳素血症和体重减轻（尤其是神经性厌食症患者）常伴有闭经以及促性腺激素脉冲分泌缺失。鉴于有观点认为内源性阿片肽张力增加可能在这两种情况下均起作用，我们对12例闭经患者静脉注射大剂量纳洛酮，其中5例患有高催乳素血症，7例患有与体重减轻相关的闭经。12例患者中有11例雌二醇水平较低（低于50 pmol/l）。纳洛酮使所有5例高催乳素血症患者的促黄体生成素（LH）和促卵泡生成素（FSH）水平显著升高。相比之下，体重减轻所致闭经患者对纳洛酮的反应是促性腺激素仅有小幅升高或未升高。两组患者的催乳素水平均无一致变化。结论是，在高催乳素血症中，而非体重减轻所致闭经中，存在由内源性阿片肽介导的对下丘脑促性腺激素释放激素分泌的重要的紧张性抑制。
