Oesterle M, Galeazzi R L
Medizinische Klinik A, Endokrinologie, Kantonsspital St. Gallen.
Praxis (Bern 1994). 1995 Jun 20;84(25-26):778-83.
In clinical endocrinology an elevated prolactin concentration in serum is often encountered. This may be either physiological during pregnancy and lactation or pathological in all other cases. The most frequent causes are drugs (dopamine antagonists, estrogens) and primary hypothyroidism. These hyperprolactinemic states have to be distinguished from prolactinomas and other tumors of the pituitary gland, which can increase the level of prolactin in the serum through different mechanisms. Drug therapy with dopamine agonists will almost always decrease prolactin levels, but will rarely cure the disease. Long-term success rates after surgery are 50% for microadenomas and 10 to 15% for macroadenomas. Therefore, the decision to operate should be made after careful discussion between the surgeon and the endocrinologist. Pregnancy will rarely cause expansion of the tumors, more often with macro- than with microadenomas. Pregnant women with prolactinomas have to be followed clinically, and drug therapy has to be instituted immediately when clinical signs of tumor progression exist.
在临床内分泌学中，血清催乳素浓度升高的情况经常出现。这在妊娠和哺乳期可能是生理性的，而在所有其他情况下则可能是病理性的。最常见的原因是药物（多巴胺拮抗剂、雌激素）和原发性甲状腺功能减退。这些高催乳素血症状态必须与催乳素瘤和垂体的其他肿瘤相区分，后者可通过不同机制使血清催乳素水平升高。使用多巴胺激动剂进行药物治疗几乎总能降低催乳素水平，但很少能治愈该疾病。微腺瘤手术后的长期成功率为50%，大腺瘤为10%至15%。因此，手术决策应在外科医生和内分泌学家仔细讨论后做出。妊娠很少会导致肿瘤增大，大腺瘤比微腺瘤更常见。患有催乳素瘤的孕妇必须进行临床随访，当出现肿瘤进展的临床体征时，必须立即开始药物治疗。
