Massara F, Genazzani A R, Camanni F, De Leo V, Molinatti G M, Müller E E
Fertil Steril. 1981 Feb;35(2):149-54. doi: 10.1016/s0015-0282(16)45314-8.
Forty-one subjects with hyperprolactinemia underwent testing on separate occasions with nomifensine, an indirectly acting dopamine agonist, and domperidone, a dopamine receptor-blocking agent. Nomifensine (200 mg orally) did not significantly modify plasma levels of prolactin (PRL) in 17 subjects in whom the existence of a pituitary tumor had been established at surgery (12 subjects) or was highly probable (5 subjects). Of the remaining 24 patients with hyperprolactinemia of uncertain etiology, 6 had PRL responsiveness to nomifensine (decrease of baseline PRL levels greater than or equal to 30%) and 18 had PRL unresponsiveness to the drug. The administration of domperidone (4-mg bolus injected intravenously) showed in 36 of the 41 patients the existence of a homogeneity between PRL responsiveness to nomifensine and PRL responsiveness to domperidone. In only five patients was failure of nomifensine to lower plasma PRL levels associated with an increase in plasma PRL levels after domperidone administration (at least doubling of baseline PRL levels). The combined application of nomifensine and domperidone tests holds promise of being a useful method for distinguishing among hyperprolactinemic subjects those with a prolactinoma.
41名高泌乳素血症患者分别接受了间接作用的多巴胺激动剂诺米芬辛和多巴胺受体阻滞剂多潘立酮的测试。对于17名经手术确诊（12名患者）或高度疑似（5名患者）患有垂体瘤的患者，口服200 mg诺米芬辛后，其血浆泌乳素（PRL）水平未发生显著变化。在其余24名病因不明的高泌乳素血症患者中，6名患者的PRL对诺米芬辛有反应（基线PRL水平降低大于或等于30%），18名患者对该药无反应。静脉注射4 mg多潘立酮后，41名患者中有36名患者的PRL对诺米芬辛的反应与对多潘立酮的反应具有一致性。只有5名患者在服用多潘立酮后，诺米芬辛未能降低血浆PRL水平，反而导致血浆PRL水平升高（至少为基线PRL水平的两倍）。联合应用诺米芬辛和多潘立酮测试有望成为区分高泌乳素血症患者中泌乳素瘤患者的一种有用方法。
