垂体微腺瘤合并高催乳素血症的成份分析及其临床意义

本文对16例高催乳素血症合并垂体微腺瘤患者利用凝胶层析技术结合放射免疫测定血清中催乳素(PRL)的成分进行分析。按卵巢功能分组,卵巢功能正常组6例,卵巢功能障碍组10例。PRL水平两组无显著差异,而大分子催乳素(BPRL) 大大分子催乳素(BBPRL)的比例正常组明显高于障碍组,单体PRL水平则障碍组显著高于正常组,说明卵巢功能障碍主要是由于较高生物活性的单体PPL引起。在溴隐亭治疗1周、4周时,PPL下降幅度正常组均明显低于障碍组,PPL下降幅度与PRL水平无关。而与BPRL BBPRL比例呈负相关,提示某些经溴隐亭治疗PRL下降不明显的高催乳素血症可能与其循环中BPRL BBPRL比例较高有关。

THE ANALYSIS OF THE SERUM PROLACTIN COMPONENTS AND THEIR CLINICAL SIGNIFICANCE IN HYPERPROLACTINEMIA WITH PITUITARY ADENOMA

The heterogeneity of serum prolactin (PRL) in sixteen hyperprolactinemic patients with pituitary microadenoma was studied by radio immunoassay after gel chromatography. The objects were divided into two groups: group 1, the normal ovarian function (6 objects); group 2, the ovarian dysfunction (10 objects). There was no significant difference of PRL levels in two groups. The proportion of Big PRL (BPRL) and Big Big PRL (BBPRL) was markedly higher in group 1 than in group 2 whereas the monomeric PRL was signi-ficantlly lower in group 1 than group 2. Since the ovarian dysfunctions are mainly caused by the increased monomeric PRL which is defined as higher bioactive component. The percentages of PRL decreased were significantlly lower in group 1 than in group 2 after 1 and 4 weeks administration of Bromocriptine and also no correlation to the PRL levels, but have a negative correlation to the proportion of BPRL and BBPRL. The results suggest that insensitivity of the serum PRL to Bromocriptine in some hyperprolactinamic patients may be due to the high proportion of BPRL and BBPRL in circulating PRL.