Luthman M, Bremme K, Eneroth P, Werner S
Department of Endocrinology, Karolinska Hospital, Stockholm, Sweden.
Gynecol Obstet Invest. 1993;35(2):80-5. doi: 10.1159/000292670.
Prolactin (PRL), growth hormone (GH), placental lactogen (PL), chorionic gonadotropin (CG), estradiol (OE), progesterone (P4) and sex hormone-binding globulin (SHBG) were measured in serum throughout gestation in 9 women with PRL-producing pituitary adenomas. They had been treated at least 1 year with the dopamine agonist bromocriptine before pregnancy occurred. All women bore healthy babies of normal birthweight. Their PRL levels did not show the successive increase seen in normal pregnancies; serum PRL was unphysiologically increased in all patients up to the 20th week of gestation, whereafter PRL levelled off and fell within the normal range. Serum PL levels were lower in the women with prolactinoma compared to healthy pregnant women, despite normal placental weight. The serum GH levels in the patients determined with an immunoassay based on a monoclonal antibody, were low or nondetectable, similar to healthy pregnant controls. In contrast, high molecular weight GH in serum as determined with a monoclonal antibody which also recognizes PL appeared to be increased in comparison with healthy pregnant women. The serum levels of CG, OE, P4 and SHBG were all within the normal range. These results show that the unphysiological secretion of PRL in pregnant women with PRL-producing pituitary adenomas is associated with decreased serum levels of PL.
对9例患有分泌催乳素垂体腺瘤的孕妇在整个孕期测定血清中的催乳素(PRL)、生长激素(GH)、胎盘催乳素(PL)、绒毛膜促性腺激素(CG)、雌二醇(E2)、孕酮(P4)和性激素结合球蛋白(SHBG)。在怀孕前,她们至少已用多巴胺激动剂溴隐亭治疗1年。所有孕妇均分娩出健康、出生体重正常的婴儿。她们的PRL水平未显示出正常妊娠时出现的连续升高;在妊娠20周前,所有患者血清PRL均出现非生理性升高,此后PRL趋于平稳并降至正常范围。尽管胎盘重量正常,但与健康孕妇相比,催乳素瘤患者的血清PL水平较低。用基于单克隆抗体的免疫测定法测定的患者血清GH水平较低或无法检测到,与健康孕妇对照组相似。相比之下,用也能识别PL的单克隆抗体测定的血清中高分子量GH与健康孕妇相比似乎有所增加。血清CG、E2、P4和SHBG水平均在正常范围内。这些结果表明,患有分泌催乳素垂体腺瘤的孕妇PRL的非生理性分泌与血清PL水平降低有关。