溴隐亭治疗垂体泌乳素大腺瘤及妊娠期停药对肿瘤的影响

Bromocriptine treatment for macroprolactinoma and the effect of drug withdrawal during pregnancy.

本文对12例垂体泌乳素大腺瘤(直径>1cm)的治疗和随访作回顾性分析。单用溴隐亭治疗后,93%患者血清泌乳素(PRL)水平迅速下降,肿瘤明显缩小。除1例未婚,1例失访,2例因药物治疗无明显效果而改为手术治疗外,余8例均获足月妊娠。妊娠期间停用溴隐亭治疗,并无肿瘤生长过分活跃的征象。结果提示,单纯溴隐亭治疗对于垂体泌乳素大腺瘤也是相当有效的。当瘤体明显缩小后可允许妊娠,妊娠后即可安全地停药。分娩或哺乳停止后,则可根据肿瘤大小及临床表现继续给予溴隐亭治疗。

Objective:To determine the value of bromocrip- tine for women with macroprolactinoma and investi- gate the effect of bromocriptine withdrawal during pregnancies.Design:12 patients with macropro- lactinoma treated between 1980 and 1993 in the sec- ond hospital affiliated to Fujian medical university were reviewed.Bromocriotine was given to all the 12 patients.Treatment was withheld shortly after con- ception in each pregnancy.Results:There was a pro- gressive decline on the serum PRL levels and on tu- mor size in 10 patients.Term pregnancies occured in 8 cases.Conclusion:Conservative bromocriptine therapy should be the routine method of management of infer- tile women with macroprolactinoma while bromocrip- tine may be safely withdrawal during pregnacy in women presenting with macroprolactinoma.