中医辨证治疗高泌乳素血症临床观察

目的：观察中医辨证治疗高泌乳素血症的临床疗效。方法：将30例高泌乳素血症患者分为肝郁气滞、肾阳虚肝郁、肾阴虚肝郁、痰湿阻滞、脾虚血瘀5个类型进行治疗。结果：30例患者中显效14例,有效13例,无效3例,有效率为90％。结论：中医辨证治疗高泌乳素血症的临床疗效显著。     

高催乳素血症与不孕的探讨

作对４０例高催乳素血症患引起不孕的原因进行了探讨，发现高催乳素血症患基础体温、经前子宫内膜活检及黄体期孕酮测定均提示黄体功能不全，是导致高催乳素血症患不孕的主要原因，经溴隐亭后，催乳素下降，基础体温黄体期正常，黄体期孕酮水平明显提高，４０例中１８例受孕，作还对溴隐亭治疗后分娩的１５例小孩作了体格和染色体检查，未发现异常，似可说明溴隐亭治疗是安全的，它不仅可用于高催乳素血症患，也可用于治     

高泌乳素血症与不孕症关系的探讨

目的 :探讨高泌乳素 (PRL)血症对女性不孕症的影响及治疗结局。方法 :对 182 0例不孕症进行血清内分泌放射免疫测定后 ,分析其中 30 8例高 PRL 血症不孕症患者的 PRL 值与月经异常症状及雌激素 (E2 )水平的关系 ;观察接受溴隐亭药物治疗后的妊娠情况。结果 :由高 PRL 血症所致的不孕症占 16 .9% ,其在原发性不孕症所占的比率明显高于继发性不孕症 (χ2 =5 6 .4 88,P <0 .0 1) ;随着 PRL 值升高 ,闭经的概率增加 (χ2 =12 4 .32 8,P <0 .0 1) ;PRL 值与 E2 水平呈负相关 (r=- 0 .72 4 ,P <0 .0 1) ;接受治疗的 2 16例中 ,妊娠率为 84 .7% ,流产率为 2 3.5 %。结论 :高 PRL 血症是不孕症、尤其是原发性不孕症的重要原因 ,PRL 值的高低与闭经症状及 E2 水平关系密切。这些患者经过溴隐亭治疗后 ,其妊娠率高、但流产率亦较高     

Effects of Oestrogen-Induced Hyperprolactinemia on the Rat Prostate

Exposure of intact rats to increasing doses of oestradiol-17 beta in the presence of a constant amount of exogenous androgen caused a dose-related increase in the concentration of zinc in the lateral lobes and a decrease in the levels of ventral lobe prolactin binding. These changes occurred concomitantly with a dose-dependent increase in plasma prolactin levels, and could not be obtained in hypophysectomized rats given the same steroid treatment. In the intact animals a dose-dependent decrease in the responsiveness of the prostaglandin E1-dependent adenylyl cyclase in the ventral lobe was observed, an effect which has earlier been shown to be prolactin mediated. The results indicate that oestrogen has indirect effects on specific parameters of prostate function by inducing a relative hyperprolactinemia. This model may be useful in studying effects of chronically and physiologically elevated levels of endogenous prolactin on the rat prostate.     

Prolactin elevation of the antipsychotic risperidone is predominantly related to its 9-hydroxy metabolite

OBJECTIVE: Treatment with the antipsychotic risperidone is frequently associated with hyperprolactinemia. The aim of this study was to evaluate the role of the main compound risperidone and its active 9-hydroxy metabolite on elevating prolactin levels. METHODS: Twenty patients with psychotic disorders, on therapy with risperidone, were studied. All patients had been receiving risperidone for at least 2.5 months, and the median daily dose of risperidone was 3 mg (range 1-10). Morning serum samples for prolactin were analyzed and investigated in relation to the serum concentrations of risperidone and 9-hydroxyrisperidone. RESULTS: Elevated prolactin levels were found in 17 (85%) of the patients. Levels of prolactin were positively correlated to the 9-hydroxyrisperidone serum concentration (r(s) = 0.48, p = 0.03) and to the daily dose of risperidone (r(s) = 0.51, p = 0.03), but did not correlate to the risperidone serum concentration. CONCLUSION: The present results suggest that 9-hydroxyrisperidone and not risperidone is the main contributor to the increased serum levels of prolactin observed in many risperidone-treated patients.     

Effect of therapy with atypical antipsychotic drugs on prolactin concentration in patients with schizophrenia and schizoaffective disorders

Plasma prolactin concentration was measured in patients with schizophrenia and schizoaffective disorders receiving therapy with risperidone, olanzapine, and quetiapine and compared with the corresponding parameter in patient receiving typical neuroleptic drug haloperidol. We evaluated the specific effects of the test drugs on prolactin concentration in men and women. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 140, No. 12, pp. 667–669, December, 2005     

Hyperprolactinemia,Clinical Considerations,and Infertility in Women on Antipsychotic Medications

Infertility, the inability to establish a clinical pregnancy after 12 months of regular unprotected sexual intercourse, is caused by a wide variety of both male and female factors. Infertility is estimated to affect between 8–12% of couples trying to conceive globally. Female factor infertility can be subdivided into the following broad categories: ovulatory dysfunction, fallopian tubal disease, uterine causes, and oocyte quality. Hyperprolactinemia causes ovulary dysfunction along with other hormonal abnormalities, such as decreased estrogen, which can lead to infertility. In this regard, antipsychotics are commonly used for both schizophrenia and bipolar disorder. The use of these medications can be associated with hyperprolactinemia and hyperprolactinemia associated infertility. Antipsychotic-induced hyperprolactinemia occurs through blockade of D₂ receptors on lactotroph cells of the anterior pituitary gland. Discontinuation of the hyperprolactinemia-inducing antipsychotic is an option, but this may worsen the patient’s psychosis or mood. If antipsychotics are determined to be the culprit of infertility, the degree of hyperprolactinemia symptoms, length of treatment with the antipsychotic, and risk of relapse should be assessed prior to discontinuation, reduction, or switching of antipsychotic medications. The treatment of a women’s mental health and her desire to have children should always be considered as treatment may influence fertility while on the medication.     

逍遥散加减对高泌乳素血症模型大鼠中枢多巴胺受体ERK信号转导通路的影响

目的:以疏肝健脾为核心,运用逍遥散加减治疗高泌乳素血症(HPRL)模型大鼠,探讨逍遥散加减对HPRL大鼠模型中枢多巴胺受体细胞外调节蛋白激酶(ERK)信号转导通路的作用机制。方法:96只SD雌性大鼠,随机分为正常组,模型组,溴隐亭组(0. 001 g·kg~(-1)),逍遥散加减高、中、低剂量组(60,30,15 g·kg~(-1)),多巴胺第一受体(D1R)拮抗剂组(SCH23390组,SCH23390+逍遥散加减中剂量组,SCH23390+溴隐亭组),多巴胺第二受体(D2R)拮抗剂组(氟哌啶醇组,氟哌啶醇组+逍遥散加减中剂量组,氟哌啶醇组+溴隐亭组)。采用垂体移植法制作HPRL大鼠模型,给药30 d后,采用蛋白免疫印迹法(Western blot)检测大鼠下丘脑癌蛋白Ras,Raf蛋白的表达;采用实时荧光定量聚合酶链式反应(Real-time PCR)检测大鼠下丘脑丝裂原活化蛋白激酶(MAPK)激酶1/2(MEK1/2) mRNA,细胞外信号调节激酶1/2(ERK1/2) mRNA的表达;采用电镜观察卵巢颗粒细胞超微结构。结果:与正常组比较,模型组Ras,Raf蛋白,MEK1/2,ERK1/2 mRNA表达显著降低(P 0. 01);运用SCH23390拮抗DIR后,与模型组比较,SCH23390组Ras,Raf蛋白,MEK1/2,ERK1/2 mRNA表达有升高趋势,运用氟哌啶醇拮抗D2R后,与模型组比较,氟哌啶醇组Ras,Raf蛋白表达有下降趋势,MEK1/2,ERK1/2 mRNA表达显著下降(P 0. 01);运用逍遥散加减治疗后,能显著提高Ras,Raf蛋白,MEK1/2,ERK1/2 mRNA表达(P 0. 01),且逍遥散加减高、中剂量组表达增加最明显(P 0. 01),效果优于溴隐亭组。电镜下模型组卵巢颗粒细胞形态及线粒体数量、结构异常,运用逍遥散加减治疗后,颗粒细胞形态和线粒体结构趋于正常。结论:逍遥散加减通过激动D2R,抑制D1R,调节ERK/MAPK信号通路,并有效改善卵巢颗粒细胞线粒体功能,促进卵泡发育,说明逍遥散加减治疗HPRL是多靶点的作用机制。     

Hypothesis: prolactin is tumorigenic to human breast: dispelling the myth that prolactin-induced mammary tumors are rodent-specific

The commonly held assumption that rodent mammary tumors resulting from elevated prolactin are species-specific, or not biologically relevant to humans, is incorrect. Substantial epidemiological, clinical, and biological evidence now exists confirming the role of prolactin in human breast cancer. This evidence is evaluated and the argument presented that the tumorigenic risk from prolactin is therefore not species-specific to rodents but directly applies to humans. Further, as the mechanisms of prolactin-induced mammary tumor promotion and development appear analogous between rodents and humans, mammary tumorigenic findings in rodent carcinogenicity bioassays are both predictive and biologically relevant to the human response. Toxicologists and regulators need to consider this in carcinogenicity risk assessments.     

体外受精-胚胎移植中暂时性高催乳素血症对妊娠的影响

目的探讨在体外受精与胚胎移植(IVF-ET)中,注射人绒毛膜促性腺激素(HCG)日血清催乳素(PRL)浓度对妊娠的影响。方法回顾性分析2005年10月至2008年3月期间127个体外受精与胚胎移植周期的资料。结果在控制性卵巢刺激(COS)中,按注射HCG日血清催乳素浓度不同分4组,依次为<30ng/mL(A组),≥30～<60ng/mL(B组),≥60～<90ng/mL(C组),≥90ng/mL(D组)。体外受精与胚胎移植的种植率分别为13.68%、24.16%、15.90%、2.86%;临床妊娠率分别为25.00%、47.17%、29.41%、7.69%。各组的种植率及临床妊娠率差异有统计学意义(χ2检验,P值分别为0.018和0.019)。进一步进行两两比较,HCG日PRL≥90ng/mL(D组)的种植率及妊娠率明显较PRL水平≥30～<60ng/mL(B组)低,差异有统计学意义(P值分别为0.005和0.009)。结论控制性卵巢刺激后血清催乳素浓度较基础水平明显升高,导致暂时性高催乳素血症。当HCG注射日血清催乳素明显升高(≥90ng/mL)时,体外受精与胚胎移植的种植率及临床妊娠率明显下降。对控制性卵...