在微泌乳素瘤手术期间，催乳素血浆浓度急剧下降并不会改变对压力的激素反应。
The hormonal response to stress is not modified by the dramatic decrease in prolactin plasma concentration during surgery for microprolactinoma.
作者信息
Guieu R, Dufour H, Devaux C, Brue T, Rosso J P, Grisoli F, Grino M, Enjalbert A, Begoud D, Broder N, Rochat H, Jaquet P
机构信息
Laboratoire de Biochimie, Faculté de Médecine Secteur Nord, UMR CNRS, Institut Fédératif J Roche, Marseille, France.
出版信息
J Neurol Neurosurg Psychiatry. 1998 Oct;65(4):502-7. doi: 10.1136/jnnp.65.4.502.
OBJECTIVES
To determine the endocrine response to surgical stress in a homogeneous population of 36 women with microprolactinomas, particularly to evaluate the effect of the sharp decrease in plasma prolactin on stress induced hormonal secretion. In addition, the effects of exogenous opiates on prolactin secretion were studied.
METHODS
The plasma kinetics of cortisol, prolactin, ACTH, GH, and beta-endorphin like immunoreactivity (beta-ELI) were analysed by including patients operated on with strict anaesthetic and surgical protocols, and by sampling blood every 10 minutes, starting at premedication up to 3 hours after induction.
RESULTS AND CONCLUSIONS
(a) Surgical stress or opiate administration did not induce prolactin release in patients with microprolactinoma. (b) The dramatic decrease in prolactin concentrations have apparently no effect on the release of other hormones involved in stress. (c) The existence of an early GH peak, independently of any surgical procedure, strongly suggests that GH is released by surgical stress whereas beta-endorphin is secreted in response to pain. Thus GH may be a useful marker of surgical stress.
目的
确定36例微泌乳素瘤女性患者这一同质群体对手术应激的内分泌反应，尤其是评估血浆泌乳素急剧下降对应激诱导的激素分泌的影响。此外，还研究了外源性阿片类药物对泌乳素分泌的影响。
方法
通过纳入采用严格麻醉和手术方案进行手术的患者，并从术前用药开始至诱导后3小时每隔10分钟采集血液样本，分析皮质醇、泌乳素、促肾上腺皮质激素（ACTH）、生长激素（GH）和β-内啡肽样免疫反应性（β-ELI）的血浆动力学。
结果与结论
（a）微泌乳素瘤患者的手术应激或阿片类药物给药未诱导泌乳素释放。（b）泌乳素浓度的急剧下降显然对参与应激的其他激素的释放没有影响。（c）独立于任何手术操作存在早期GH峰值，强烈提示GH由手术应激释放，而β-内啡肽是对疼痛作出反应而分泌。因此，GH可能是手术应激的有用标志物。
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