阿立哌唑对抗精神病药物所致的老年精神分裂症患者高催乳素血症的影响

目的:探讨阿立哌唑对抗精神病药物所致的老年精神分裂症患者高催乳素血症的影响.方法:63例抗精神病药所致高催乳素血症的老年精神分裂症患者随机分为研究组(33例)和对照组(30例).两组沿用原有抗精神病药物,研究组加用阿立哌唑5 mg/d持续12周.分别于入组前、入组4、8、12周末检测血清催乳素水平,同时采用简明精神病评定量表(BPRS)和治疗中出现的症状量表(TESS)评定精神病性症状及药物不良反应. 结果:入组4、8、12周末研究组血清催乳素水平较入组前及对照组显著降低(P均＜0.05);对照组入组前后血清催乳素水平差异无统计学意义(P均＞0.05).两组人组前后BPRS、TESS评分差异无统计学意义(P均＞0.05). 结论:阿立哌唑可有效降低抗精神病药物所致老年精神分裂症患者血清催乳素水平增高,且并未增加药物不良反应.     

Persistent increase of PRL after oral contraceptive treatment

 Background: The mechanism involved in estrogen induced hyperprolactinemia is not completely known, although one of the possible theories suggest inhibition of dopaminergic tone. Our objective was to study the mechanism implied in the increment of PRL levels as a consequence of oral contraceptive treatment and possible modifications in TSH levels. Material and methods: We performed a trial on 21 healthy women, nulliparas. We administered 35 μg of Etinil-Estradiol (EE) and 2 mg of Ciproterone Acetate (CA) for a period of 12 months. Stimulation tests with Metoclopramide and TRH were carried out before treatment, after 3, 6 and 12 months of treatment and finally 6 months after cessation of treatment. Results. Basal levels of PRL (×–₁=12.62 ng/ml) increased significantly (p<0.05) during the year of treatment (×–₁₂=17.04 ng/ml) and maintained higher levels 6 months after cessation (×–₁₈=17.53 ng/ml). Maximum values obtained in response to metoclopramide (×–₁=154.78) were significantly higher after 12 months (×–₁₂=173.29), persisting 6 months after cessation of treatment (×–₁₈=245.28). We also observed significant differences in the maximum response of TSH to metoclopramide during the same period of study (×–₆=2.45), (×–₁₂=2.76) and (×–₁₈=2.07) respectively (p<0.05). We did not find changes in PRL and TSH responses to TRH stimulation after a year of treatment with EE and CA. Conclusion: Treatment with EE (35 μg) and CA (2 mg) induces an increase in PRL levels that persist 6 months after cessation of treatment. Our results rule out the possibility that this increase in PRL is due to a decrease in dopaminergic tone or an increase in TRH sensitivity. Received: January 1999 / Accepted: 4 May 1999     

男性慢性肝病患者基础血清催乳素的测定及其临床意义

应用RIA法检测了62例慢性肝炎和肝硬化患者基础血清催乳素(PRL)和雌二醇(E_2)的浓度。结果表明慢性肝炎和肝硬化血清PRL水平均高于正常,其中尤以肝性脑病患者最为显著。本文认为其增高的机制可能与支链氨基酸减少或支/芳氨基酸比例失调和下丘脑假性神经介质积聚有关,而与血清E_2水平无恒定关系。     

Mechanistic Aspects of Crosstalk Between GH and PRL and ErbB Receptor Family Signaling

Growth hormone (GH) and prolactin (PRL) are anterior pituitary hormones that have multiple roles in growth and metabolism. Both hormones are important in mammary development and breast cancer. The epidermal growth factor (EGF) family of peptides and the receptors that they activate (the ErbB family) are also major players in mammary biology and pathophysiology. Recent studies in signal transduction have highlighted the interplay between signaling pathways referred to as crosstalk. In this review, cell biological and signaling studies related to crosstalk between GH and PRL and the ErbB family are discussed. In particular, the role of GH- and PRL-induced phosphorylation of ErbB receptors in regulating EGF responsiveness is highlighted with attention to potential pathophysiological relevance.     

动脉瘤性蛛网膜下腔出血病人血清FSH LH PRL GH的浓度变化

目的　研究动脉瘤性蛛网膜下腔出血 (SAH)病人血清卵泡刺激素 (FSH)、黄体生成素 (LH)、泌乳素 (PRL)、生长激素 (GH)的浓度变化规律。方法　对 35例动脉瘤性SAH病人发病后 1～ 3、7～ 9、13～ 15d血清FSH、LH、PRL、GH的浓度进行动态观察 ,用TCD检测大脑中动脉血流速度 (VMCA)。结果　动脉瘤性SAH病人血清FSH、LH、PRL、GH浓度在发病后 1～3、7～ 9d各均值明显高于对照组 ,尤以发病后 7～ 9d变化最明显 ;术前、术后有脑血管痉挛 (CVS)组和非CVS组也有明显差异。结论　动脉瘤性SAH病人血清FSH、LH、GH、PRL含量与SAH的病情演变、CVS程度有关 ,并可判断预后。     

女性不孕症患者的激素指标特征与临床诊断价值分析

目的：研究女性不孕症患者的促卵泡激素（FSH）、泌乳素（PRL）、雌二醇（E2）、促黄体生成素（LH）等指标特征对于临床诊断价值。方法选取2011年2月至2013年2月在该院治疗的128例不孕症患者为研究对象,根据月经情况分为月经正常组40例和月经紊乱组88例,选取同期健康体检女性100例为对照组。所有研究对象在月经2～3 d抽空腹静脉血5 mL ,分离血清,应用全自动化学发光检测仪进行 FSH、PRL、E2、LH等激素水平进行测定,比较月经正常组、月经紊乱组和对照组患者的FS H、PRL、E2、L H等激素水平。分析FS H、PRL、E2、L H等激素对不孕症的影响。同时随访比较不孕症患者治愈后与对照组FSH、PRL、HL、E2等激素水平情况。结果月经紊乱组患者的FS H、PRL、L H激素水平明显高于对照组,差异具有统计学意义（ P＜0．05）;E2激素水平明显低于对照组,差异具有统计学意义（P＜0．05）。月经正常组患者的 FSH、PRL、LH、E2等激素水平与对照组比较,差异无统计学意义（ P＞0．05）。不孕症患者治愈后与对照组比较,两组的 FS H、PRL、E2、L H等激素水平差异无统计学意义。结论女性不孕症患者的FS H、PRL等激素的测定对临床上诊断不孕症具有重要意义。同时也是监测不孕症治疗效果的一种重要方法。     

Effects of overexpression of growth hormone-releasing hormone on the hypothalamo-pituitary-gonadal function in the mouse

In this investigation, the neuroendocrine alterations induced by high, chronic circulating levels of endogenous growth hormone (GH) were studied in transgenic mice with ectopic overexpression of the human growth hormone-releasing hormone (h-GH-RH) gene. In comparison with their normal littermates, transgenic h-GH-RH mice had elevated plasma levels of GH, prolactin (PRL), and corticosterone. In addition, they had elevated body, liver, kidney, spleen, and pituitary weights compared with normal mice. Testis and seminal vesicle weights were also increased in transgenic mice. Although basal plasma luteinizing hormone (LH) levels, plasma estradiol levels in females, and plasma testosterone levels in males did not differ significantly between normal and transgenic animals, the LH response to castration was severely impaired in transgenic mice of both sexes. Among the biogenic amines studied in the hypothalamus, only dopamine concentrations were significantly lower in transgenic animals compared with their normal littermates. This decrease in hypothalamic dopamine may be related to the hyperprolactinemia in transgenic animals. In vitro, pituitaries from transgenic mice released significantly higher amounts of GH, and although the basal release of LH was not different in both normal and transgenic mice, the response to gonadotropin-releasing hormone was significantly smaller in transgenic mice. Cultured anterior pituitary cells from transgenic mice secreted high quantities of GH and PRL in vitro, but these quantities significantly decreased from 1 to 8 wk in culture. These results show that high, persistent levels of circulating endogenous GH induce alterations in neuroendocrine functions related to the hypothalamopituitary-gonadal and the hypothalamo-pituitary-adrenal axes.     

Responsiveness of tuberoinfundibular dopaminergic neurons to 5-hydroxytryptophan

Serotonin is known to stimulate prolactin secretion by decreasing tyrosine hydroxylase (TH) activity in the tuberoinfundibular dopaminergic (TIDA) neurons. However, the effects of aging on the responsiveness of TIDA neurons to serotonin are not known. An effective way to increase serotonergic activity is to administer 5-hydroxytryptophan (5-HTP), a serotonin precursor. The present study was done to investigate the effects of 5-HTP on TIDA neuronal activity in aging animals. Middle-aged (10–12 mo), old (18–20 mo), and very old (22–24 mo) female Sprague-Dawley rats were bilaterally ovariectomized. Ten days later, they were injected iv with 50 mg/kg body wt of 5-HTP or the vehicle for 5-HTP (PBS-HCl). Twenty minutes later, m-hydroxybenzylhydrazine (NSD), a DOPA decarboxylase inhibitor, was administered. Ten minutes later, the animals were killed, and tyrosine hydroxylase (TH) activity was determined by measuring l-DOPA accumulation in the stalk median eminence by HPLC-EC. In all three groups, administration of 5-HTP increased serum prolactin levels significantly. In control middle-aged rats, TH activity (l-DOPA pg/μg protein) was 33.0 ± 5.6. Treatment with 5-HTP decreased TH activity by 60%. Similarly, 5-HTP treatment decreased TH activity by 52 and 56% in 18- to 20- and 22- to 24-mo-old rats, respectively, compared to the control rats. The magnitudes of the 5-HTP-induced decreases in TH activities in middle-aged, old, and very old rats were not different from each other. These results indicate that TIDA neuronal responsiveness to serotonin does not change with age and that 5-HTP is capable of stimulating PRL release even in very old rats.