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1.
阿立哌唑治疗利培酮所致男性高催乳素血症研究   总被引:4,自引:0,他引:4  
目的:探讨阿立哌唑治疗利培酮所致男性高催乳素血症的疗效。方法:将60例利培酮所致高催乳素血症的男性精神分裂症患者随机分为两组,分别用阿立哌唑(30例)及安慰剂(30例)治疗,疗程6周。分别于治疗前、治疗6周检测血清催乳素(PRL)水平,评定简明精神病评定量表(BPRS)及治疗中出现的症状量表(TESS)。结果:治疗6周末,阿立哌唑组PRL较治疗前显著下降(P〈0.001),男性乳房女性化消失(11/13),自发泌乳消失(18/19);安慰剂组PRL治疗前后差异无显著性(P〉0.05)。结论:阿立哌唑可有效治疗利培酮所致的男性高催乳素血症。  相似文献
2.
芍药甘草汤治疗高催乳素血症对照研究   总被引:1,自引:1,他引:16  
目的:探讨芍药甘草汤对女性精神分裂症患者应用利培酮后出现高催乳素血症的疗效。方法:对女性精神分裂症患者以利培酮治疗后催乳素水平≥50μg/L伴月经稀发或闭经者纳入交叉对照研究,共18例。利培酮继续原有剂量,先后合并芍药甘草汤或溴隐亭治疗各4周,间隔4周,总疗程12周。测定血清催乳素、雌二醇、睾酮、孕酮浓度,评定阳性与阴性症状量表(PANSS)和副反应量表(TESS)。结果:芍药甘草汤或溴隐亭治疗均可降低催乳素浓度(P<0.01),服芍药甘草汤后催乳素浓度平均降低(18.0±24.3)μg/L;服溴隐亭后平均降低(25.3±24.4)μg/L,二者相仿(t=-1.054,P>0.05);经治疗9例患者月经来潮。结论:芍药甘草汤可用于治疗利培酮所致的高催乳素血症,未见明显不良反应。  相似文献
3.
高泌乳素血症166例分析   总被引:1,自引:0,他引:1  
目的探讨高泌乳素血症(HPRL)的临床表现、治疗方法及其与泌乳素腺瘤的关系。方法分析同济大学附属东方医院神经外科自2005年1月至2010年1月确诊为HPRL的166例患者临床资料、激素指标,其中4年为回顾性分析,1年为前瞻性研究。 结果大部分患者的年龄分布在20~40岁,月经不调是最常见的临床表现,见于141例患者(84.9%);其次是溢乳,见于114例患者(68.7%)。发病原因中,泌乳素微腺瘤见于62例患者(37.3%),无功能性垂体大腺瘤见于26例患者(15.7%)。泌乳素微腺瘤患者泌乳素水平为(161.2±60.6)ng/mL,和其他任一原因导致的HPRL患者泌乳素水平比较,差异均有统计学意义(P≤0.05)。 结论泌乳素微腺瘤是HPRL最常见的病因,其次为特发性HPRL。单从血清泌乳素的水平并不能确定患者是否一定存在微腺瘤。  相似文献
4.
许多抗精神病药物可导致精神分裂症患者合并高催乳素血症疾病,经典抗精神病药物不仅能使PRL水平明显升高,而且药物的效价强度与催乳素呈正相关。非经典抗精神病药对5-HT受体及多巴胺D2受体的亲和力具有相对特异性,锥体外系副作用轻,临床疗效显著,对催乳素水平影响小,但临床应用过程中不同药物对催乳素的影响存在差异,药理机制复杂还有待于进一步的探讨。  相似文献
5.
6.
Gynecomastia developed in two epileptic patients some months after the addition of oral fluoresone 750 mg daily to the phenobarbital and phenytoin already being administered. The common systemic diseases that may give rise to gynecomastia were excluded. One of the patients presented hyperprolactinemia and a raised estrogen/androgen ratio but the hormone levels were not raised in the other. The onset of symptoms after fluoresone in both cases is highly suggestive, although the pathogenetic mechanism is not clear.
Sommario Una ginecomastia insorta in due epilettici viene riportata. Il quadro si è sviluppato alcuni mesi dopo che ad un precedente trattamento con PB e PHT si era aggiunto fluoresone alla dose di 750 mg/die per os. Le comuni malattie sistemiche che possono determinare una ginecomastia sono state escluse. I rilievi ormonali hanno evidenziato soltanto in un caso un'iperprolattinemia ed un aumento del rapporto estrogeni-androgeni circolanti. La relazione temporale fra somministrazione del fluoresone e comparsa del quadro appare cruciate, tuttavia il meccanismo patogenetico resta da chiarire.
  相似文献
7.
Studies were undertaken to evaluate the effects of chronic hyperprolactinemia (HYP) on catecholamine concentrations and turnover rates in brain regions of the female rat. HYP was induced by inoculation of tissue derived from the prolactin secreting MtTW15 tumor. When serum prolactin (PRL) levels were moderately elevated, medial basal hypothalamus (MBH) dopamine (DA) turnover was enhanced and DA concentrations were moderately reduced. Later, as serum PRL levels increased to greater than 10 micrograms/ml, DA concentrations were further reduced and DA turnover was concomitantly reduced to below pre-tumor levels. In the preoptic area-anterior hypothalamus (POA-AH), DA concentrations were reduced as PRL levels increased and this was associated with a reduction in DA turnover. Between 5 and 8 weeks of tumor growth, DA turnover remained low, but DA concentrations increased. In the neurointermediate lobe of the pituitary (NIL) the tumor reduced DA turnover at 5 weeks only. Norepinephrine (NE) turnover, but not concentration, was reduced in both the POA-AH and MBH. Surgical removal of the tumor at 5 weeks of growth reduced serum PRL levels to near normal, but MBH DA concentrations and turnover remained depressed while POA-AH and NIL DA levels and turnover increased. Despite removal of the tumor, NE turnover remained depressed in both the MBH and POA-AH. These studies indicate that severe chronic HYP causes progressive alterations in hypothalamic catecholamine neurons which are not reversed by normalization of serum PRL levels. These results suggest that chronic HYP can cause long-lasting effects on some DA and NE neuronal systems.  相似文献
8.
The effects of hyperprolactinemia on catecholamine turnover in the medial basal hypothalamus (MBH) and on the luteinizing hormone-releasing hormone (LH-RH) concentrations in MBH and hypophyseal portal blood were investigated in female Wistar rats. Chronic endogenous hyperprolactinemia was produced by implantation of anterior pituitary glands under the kidney capsule. Catecholamine turnover in the MBH was studied by inhibiting monoamine oxidase and then measuring the accumulation of catecholamines by high-performance liquid chromatography with electrochemical detection. Rats bearing pituitary transplants exhibited: (1) persistent vaginal diestrus within 3–6 days of the implantation; (2) increased serum concentrations of prolactin (PRL); (3) decreased serum concentrations of luteinizing hormone (LH); (4) increased pituitary concentrations of LH and follicle-stimulating hormone (FSH); (5) increased turnovers of dopamine in the MBH; and (6) decreased concentrations of LH-RH in the MBH and in plasma of hypophyseal portal blood.These findings suggest that chronic hyperprolactinemia may increase dopaminergic tone in the MBH that may inhibit LH-RH secretion from the MBH, and LH release from the pituitary. These processes may be responsible for disturbances of cyclic pituitary-ovarian activity.  相似文献
9.
Extracellular action potentials were recorded from 691 neurons in the ventromedial hypothalamus (VMH) of urethane anesthetized female rats under acute and chronic sham-operated and hyperprolactinemic conditions. Hyperprolactinemia was produced by transplanting pituitaries under the kidney capsules. Neuronal excitability was recorded and analyzed during spontaneous, baseline activity and following the iontophoretic application of prolactin, dopamine (DA) and luteinizing hormone-releasing hormone (LH-RH). No statistically significant changes were observed in the spontaneous electrical activity of VMH neurons under the conditions tested. Of the responsive neurons, approximately 90% of the neurons recorded and tested with prolactin displayed an increase in firing activity while DA produced a decrease, independent of the endogenous plasma prolactin levels (basal or elevated). However, the response to LH-RH was modified in the chronic hyperprolactinemic animal. The predominant response of VMH neurons to LH-RH in acute sham-operated and hyperprolactinemic as well as in chronic sham-operated animals was one of inhibition, while in the chronic hyperprolactinemic animal, the application of LH-RH initiated excitation rather than inhibition. These results provide evidence that chronic (long-term) exposure to elevated prolactin levels is a sufficient stimulus to modify the neuronal response pattern of VMH nerve cells to iontophoretically applied LH-RH but not to prolactin nor to DA.  相似文献
10.
Adult male rats were rendered hyperprolactinemic by two different methods. Some animals received subcutaneous implants of diethylstilbestrol (DES) or empty capsules. After 2 months the capsules were removed. Other rats received 3 anterior pituitary homografts under the kidney capsule or had sham surgery. The DES-treated rats were killed 8 months after capsule removal, while pituitary-grafted rats were killed 4 or 12 months after surgery. The DES-treated rats had hyperplastic anterior pituitaries, and both the DES-treated rats and the rats with anterior pituitary homografts were hyperprolactinemic. The activity of the TIDA neurons, as evidenced by dopamine (DA) synthesis in the median eminence (ME), was markedly and comparably elevated in both of these experimental groups of rats when compared to their respective controls. These data: show that the maintenance of hyperplastic pituitaries 8 months after DES withdrawal is not due to impaired function of the TIDA neurons; and provide no evidence for a neurotoxic effect of prolonged hyperprolactinemia on the response of the TIDA neurons to elevated PRL.  相似文献
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