Bussen S, Brosemann N, Steck T
Department of Obstetrics and Gynecology, University of Würzburg, Germany.
Gynecol Endocrinol. 1996 Apr;10(2):83-90. doi: 10.3109/09513599609097896.
The objective was to define the diagnostic validity of prolactin response tests by comparing the stimulating effect of thyrotropin-releasing hormone (TRH) and metoclopramide on prolactin secretion in patients with and without functional hyperprolactinemia. Prolactin response studies were performed in 18 patients with functional hyperprolactinemia (defined as prolactin serum levels > or = 16 and < 50 ng/ml during the follicular phase without evidence of prolactinoma) and 18 controls with similar age who had normal serum prolactin levels. Tests were done on the 7th, 8th or 9th day of the follicular phase under standardized conditions (at 08.00-09.00, after a 1-h rest and overnight fasting) with 200 micrograms TRH or 10 mg metoclopramide i.v. After metoclopramide, higher maximal prolactin levels were observed in the study group as well as in the control group than after TRH (metoclopramide mean: 243 +/- 62 ng/ml vs. 181 +/- 100 ng/ml, U-test: p = 0.0019; TRH mean: 101 +/- 23 ng/ml vs. 41 +/- 20 ng/ml, U-test: p = 0.0001). There was no significant difference in the relative increment of prolactin serum levels between both groups, neither after metoclopramide nor after TRH (after metoclopramide, mean: 13.5 +/- 5.8 vs. 17.2 +/- 9.2, U-test: p = 0.137; after TRH, mean 3.6 +/- 1.1 vs. 3.8 +/- 1.9, U-test: p = 0.899). No correlation between prolactin basal and peak levels, either after TRH or after metoclopramide, could be found, neither in the study (metoclopramide test: p = 0.738; TRH test: p = 0.076) nor in the control group (metoclopramide test: p = 0.331; TRH test: p = 0.360). While significantly higher prolactin peaks were recorded after metoclopramide than after TRH in both groups, no difference in the response to TRH and metoclopramide, regarding absolute and relative increment, could be found.
目的是通过比较促甲状腺激素释放激素（TRH）和甲氧氯普胺对有或无功能性高泌乳素血症患者泌乳素分泌的刺激作用，来确定泌乳素反应试验的诊断有效性。对18例功能性高泌乳素血症患者（定义为卵泡期血清泌乳素水平≥16且＜50 ng/ml，无泌乳素瘤证据）和18例年龄相仿、血清泌乳素水平正常的对照者进行了泌乳素反应研究。在卵泡期的第7、8或9天，在标准化条件下（08:00 - 09:00，休息1小时且过夜禁食后），静脉注射200微克TRH或10毫克甲氧氯普胺进行测试。注射甲氧氯普胺后，研究组和对照组的泌乳素最高水平均高于注射TRH后（甲氧氯普胺均值：243±62 ng/ml对181±100 ng/ml，U检验：p = 0.0019；TRH均值：101±23 ng/ml对41±20 ng/ml，U检验：p = 0.0001）。两组之间泌乳素血清水平的相对增加值在注射甲氧氯普胺后和注射TRH后均无显著差异（注射甲氧氯普胺后，均值：13.5±5.8对17.2±9.2，U检验：p = 0.137；注射TRH后，均值3.6±1.1对3.8±1.9，U检验：p = 0.899）。无论是在研究组（甲氧氯普胺试验：p = 0.738；TRH试验：p = 0.076）还是对照组（甲氧氯普胺试验：p = 0.331；TRH试验：p = 0.360）中，均未发现TRH或甲氧氯普胺注射后泌乳素基础水平与峰值水平之间存在相关性。虽然两组中注射甲氧氯普胺后的泌乳素峰值均显著高于注射TRH后，但在绝对增加值和相对增加值方面，未发现对TRH和甲氧氯普胺的反应存在差异。
