【作者】 王丽； 吕淑兰； 孙婷； 曹缵孙；

【Author】 WANG Li LV Shu-lan SUN Ting CAO Zuan-sun Department of Gynaecology and Obstetrics,the First affiliated Hospital of Xi’an Jiaotong University,Shanxi Xi’an 710061

【机构】 西安交通大学第一附属医院妇产科；

【摘要】 目的：探讨高催乳素血症(HPRL)患者的病因、临床特点及诊治原则。方法：回顾性分析近2年在西安交通大学第一附属医院妇产科生殖内分泌门诊及研究室就诊的48例女性高催乳素血症患者的临床资料。结果：48例高催乳素血症患者中,垂体微腺瘤22例,巨腺瘤1例,空蝶鞍综合征2例,原发性甲状腺功能减低2例,多囊卵巢综合征(PCOS)5例,药物因素所致3例,特发性高催乳素血症13例；1例巨腺瘤应用γ刀后加溴隐亭治疗,2例原发性甲状腺功能减低补充甲状腺激素,5例多囊卵巢综合征患者用二甲双胍加安体舒通治疗,余40例均服用溴隐亭治疗；41例血清催乳素降至正常范围,14例溢乳明显减少,8例溢乳停止,21例月经恢复正常,16例 B 超监测有排卵并获妊娠,4例分娩正常婴儿。结论：高催乳素血症是育龄期妇女不孕症的主要原因之一,而垂体催乳素腺瘤是女性高催乳素血症的最常见原因,HPRL 的临床表现为不孕、月经稀发、闭经、溢乳、流产、头痛、性欲减低等,其治疗原则是针对病因处理,除垂体大腺瘤神经压迫症状需手术治疗外,溴隐亭是治疗高催乳素血症首选的安全且有效的药物,可使症状改善,瘤体缩小,月经恢复并可妊娠,其应用从小剂量开始,显效后应逐渐停药以防止血清催乳素反弹性升高。更多还原

【Abstract】 Objective TO study the etiology,clinical characteristic,diagnosis and treatment of hyperprolactinemia patients.Method The data of 48 cases of woman hyperprolactinemia in reproductive endocrine clinic and laborat- ory in the department of gynaecology and obstetrics of the first affiliated hospital of Xi’an Jiao Tong university during the recent two years were analyzed retrospectively.Results The pathogeny of the 48 HPRL patients are pituitary microadenoma(22 cases),macroadenoma(1 case),empty sella syndrome(2 cases),primary hypoth- yroidism(2 cases),polycystic ovarian syndrome(5 cases),drug agent(3 cases)and unknown causes(13 cases).1 case of macroadenoma was treated with Bromocryptine afterγknife,2 cases of primary hypothyroidism were su- pplied thyroid hormone,5 cases of PCOS were treated with metformin and antisterone,and the other 40 cases we- re all treated with bromocryptine.41 cases serum PRL reduced to normal range,14 cases galactorrhea were redu- ced significantly,8 cases stoped galactorrheaing,21 cases returned normal menstruation,16 cases returned ovula- tion and obtained pregnancy,4 cases delivered normal infants.Conclusion hyperprolactinemia is one of the prim- ary reasons of sterility among women of reproductive age,and The the very common pathogeny of woman HPRL is prolactinoma.The symptoms of prolactinoma are sterility,oligomenorrhea,amenorrhoea,galactorrhea,abortion, headache and reduced sexual desire,etc.We treated them according to their pathogeny.Prolactinoma patients we- re treated with drugs except macroadenoma which can cause nerval oppressive symptom,bromocryptine is the fir- st preferred drug,it can improve symptom,reduce tumor size,return normal menstruation and obtain pregnance. Bromocryptine should use from low dose,and reduce gradually after its effect to prevent flexiblly advance of se- rum PRL.更多还原