巨泌乳素血症患者血清性激素和甲状腺激素水平研究

目的探讨巨泌乳素血症(M-PRL)在体内产生和集聚的可能机制。方法选取高泌乳素(HPRL)患者50例、MPRL患者50例和健康人群25例分别作为HPRL组、M-PRL组和对照组,采用化学发光法检测3组血清性激素和甲状腺素水平,对检测结果进行统计分析。结果 M-PRL组、HPRL组血清睾酮、性激素结合球蛋白(SHBG)水平均高于对照组,差异有统计学意义(P0.05);M-PRL组、HPRL组血清雌二醇水平低于对照组,差异有统计学意义(P0.05);M-PRL组血清孕酮水平低于对照组,差异有统计学意义(P0.05);M-PRL组血清睾酮、雌二醇、促黄体生成素(LH)、促卵泡生成素(FSH)、SHBG水平和LH/FSH比值与HPRL组比较,差异无统计学意义(P0.05)。结论 M-PRL血症患者体内可能存在一定程度的性腺激素水平异常和自身免疫状态异常。     

Drugs and prolactin

Medications commonly cause hyperprolactinemia and their use must be differentiated from pathologic causes. The most common medications to cause hyperprolactinemia are the antipsychotic agents, although some of the newer atypical antipsychotics do not do so. Other medications causing hyperprolactinemia include antidepressants, antihypertensive agents, and drugs which increase bowel motility. Often, the medication-induced hyperprolactinemia is symptomatic, causing galactorrhea, menstrual disturbance, and erectile dysfunction. In the individual patient, it is important differentiate hyperprolactinemia due to a medication from a structural lesion in the hypothalamic–pituitary area. This can be done by stopping the medication temporarily to determine if the prolactin (PRL) levels return to normal, switching to another medication in the same class which does not cause hyperprolactinemia (in consultation with the patient’s physician and/or psychiatrist), or by performing an MRI or CT scan. If the hyperprolactinemia is symptomatic, management strategies include switching to an alternative medication which does not cause hyperprolactinemia, using estrogen/testosterone replacement, or cautiously adding a dopamine agonist.     

高泌乳素血症对女性精神分裂症患者的影响

目的:探讨高泌乳素血症对女性精神分裂症患者疗效及生活质量的影响。方法:将女性精神分裂症患者82例,分为研究组42例(伴有高泌乳素血症)及对照组40例(不伴高泌乳素血症)。以阳性与阴性症状量表(PANSS)、副反应量表(TESS)、生活质量综合评定问卷(GQOLI)评定的疗效、不良反应及生活质量。观察6个月。结果:第6个月末,研究组PANSS减分低于对照组(P<0.05)。GQOLI总分、躯体健康维度、心理健康维度、社会功能维度较入组时分值亦下降(P均<0.01);与对照组比较分值显著下降(P<0.01)。结论:伴有高泌乳素血症的女性精神分裂症患者的疗效差,生活质量下降。     

伽玛刀治疗高泌乳血症性垂体腺瘤不孕症

目的:初步探讨伽玛刀治疗高泌乳素血症性垂体腺瘤不孕症女性患者的疗效。方法:33例患有不孕症的高泌乳素血症性垂体腺瘤女性患者经过伽玛刀治疗,肿瘤体积平均值(1.09±1.05)cm3。给予治疗剂量:平均中心剂量(43.9±8.7)Gy,平均周边剂量(20.9±2.6)Gy。结果:31例患者经过16～71个月的随访,7例患者未能怀孕(2例由于子宫发育异常、3例人工避孕),1例因出现宫外孕人工流产,23例患者正常怀孕,所生育的15个婴儿发育正常。从MR影像上,肿瘤控制率为95.2%。虽然血清泌乳素水平因怀孕和哺乳而有波动,但有85.7%的患者高泌乳素血症减轻或消失。结论:立体定向放射外科伽玛刀并非是泌乳素分泌性垂体腺瘤患者的禁忌证,其能改善患者生育能力。     

诱发排卵治疗高泌乳素血症性不孕23例临床分析

目的：探讨溴隐亭联合诱发排卵药物治疗高泌乳素血症性不孕的临床疗效。方法：对23例由高泌乳症引起的不孕症患者均经不孕症系统检查，排除其它病因或预先治疗器质性疾病。对本病以溴隐亭治疗为主，联合应用促排卵药物。结果：23例患者均在3个月内恢复月经；总妊娠率达100％，3个月内妊娠14例（60．9％），3－6个月妊娠8例（34．8％），6－9个月妊娠1例（4．3％）；单纯溴隐亭治疗11例，加用促排卵药物12例。结论：治疗高泌乳素血症性不孕，应完善不孕症系统检查，明确病因诊断，应用溴隐亭联合诱发排卵治疗可提高疗效、缩短疗程，减少溴隐亭用量。     

Effect of increased prolactin and psychosocial stress on erectile function

Sexual dysfunctions in men are complex disorders that consist of organic and psychogenic components. The most common sexual dysfunction is erectile dysfunction. It is the inability to achieve or maintain an erection for satisfactory sexual performance. This disorder can be caused by high blood pressure, heart disease, vascular problems, psychological and hormonal factors such as problems with testosterone and prolactin levels. In this study, we tested the relationship between erectile dysfunction, hyperprolactinemia and psychosocial stress. Clinical examinations of 60 patients with erectile dysfunction, which also included psychosocial stress, focussed on patient history, comprehensive sexological examination, biochemical analyses of serum prolactin, total testosterone and thyroid-stimulating hormone with psychometric evaluation of erectile function and a checklist of trauma symptoms (TSC-40). The results show significant Spearman correlations of psychometric evaluation of erectile function with prolactin (R = .50) and results of the trauma checklist score (R = .55) and significant Spearman correlations between TSC-40 and prolactin (R = .52). This result indicates a significant relationship between erectile dysfunction, hyperprolactinemia and stress symptoms in men.     

SEX HORMONE STATUS IN MALE RATS AFTER EXPOSURE TO 50 HZ, 5 MTESLA MAGNETIC FIELD

The question of whether extremely low frequency magnetic fields can affect biological system has attracted attention. The theoretical possibility of such an interaction is often questioned and the site of interaction is unknown. The influence of extremely low frequency magnetic field of 50 Hz, 5 mTesla on sex hormone status was studied. 60 male albino rats were divided into 6 groups and were continuously exposed to 50 Hz, 5 mTesla magnetic field generated by magnetic field chamber for periods of 1, 2 and 4 weeks. For each experimental point, sham treated group was used as a control. Assay of serum testosterone LH, FSH, and prolactin were performed. Serum testosterone showed no significant changes. FSH showed significant increase than sham exposed group after 1 week magnetic field exposure. LH showed significant increase than sham exposed group only after 4 weeks magnetic field exposure, while serum prolactin hormone level showed a significant increase in all magnetic field exposed groups than sham exposed animals. Exposure to 50 Hz, 5 mTesla magnetic field for periods of 1, 2 and 4 weeks has no effect on testosterone level, some changes on FSH and LH serum levels and increase in serum prolactin level.     

中西医结合治疗高催乳素血症不孕症临床分析

目的:观察中西医治疗高催乳素血症不孕症患者43例的的临床疗效。方法:将86例高催乳素不孕症患者,随机分为对照组、治疗组两组。对照组43例患者给予溴隐亭治疗,治疗组加服自拟疏肝补肾汤,连服3个月。观察两组患者的临床疗效、性激素[包括催乳素(PRL)、黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、睾酮(T)]水平,临床症状积分及妊娠情况等。结果:治疗组、对照组的临床疗效95.3%、79.1%;治疗后两组均可降低PRL水平,提高E2、P水平(P0.05);但治疗组在临床症状改善方面明显优于对照组(P0.05);治疗组妊娠率显著高于对照组(P0.05)。结论:中西医治疗高催乳素血症不孕症具有良好的疗效,可改善患者临床症状,提高妊娠率,减少溴隐亭的不良反应,值得临床推广应用。     

经颅磁刺激对精神分裂症患者催乳素水平的影响

目的探讨经颅磁刺激（rTMS）治疗抗精神病药所致高催乳素血症的疗效及安全性。方法将61例利培酮所致高催乳素血症的慢性精神分裂症随机分为两组,研究组（31例）予以低频rTMS刺激,对照组（30例）以假rTMS刺激治疗;并观察血清催乳素、PANSS表、17项汉密尔顿抑郁量表的情况。结果①研究组rTMS刺激后PRL水平[（27.9±7.1）μg/L]较治疗前[（101.5±41.2）μg/L]下降,差异有统计学意义（P〈0.01）;对照组差异无统计学意义（P〉0.05）;研究组治疗1个月后复测PRL[（96.7±38.3）μg/L],已恢复至治疗前水平（P〉0.05）。②治疗前后两组患者PANSS及HAMD17评分变化均无统计学意义（P均〉0.05）。结论低频rTMS治疗可使慢性精神分裂症患者血清高催乳素短期下降。