小剂量多巴胺对重症患者血清催乳素浓度的影响

Effect of Low-dose Dopamine on Serum Concentrations of Prolactin in Critically Patients

目的探讨小剂量多巴胺对重症患者血清催乳素浓度的影响,比较不同血清样本催乳素浓度水平的差异.方法取患者基础血清即样本一;常规治疗基础上,经静脉插管使用小剂量多巴胺[2.5μg/(kg·min)]8h后取血清即样本二;停止使用小剂量多巴胺8h后血清即样本三.使用催乳素酶联免疫发光试剂盒分别测定三种血清样本催乳素浓度.结果64%患者基础血清催乳素浓度高于正常水平;使用小剂量多巴胺2.5μg/(kg·min)8h后,血清催乳素浓度均值从744.96mU/L下降至124.9mU/L(降低了83.2%),且有30%的患者表现为低血清催乳素;停用多巴胺8h逆转了此变化趋势,并呈现出82.1%的上调.结论应激可促进催乳素分泌,使血浆催乳素浓度上升.小剂量多巴胺的使用可以显著降低催乳素的血清浓度,导致细胞免疫功能下降,感染的可能性增加,而停用多巴胺可以逆转这种趋势.

Objective To investigate the effect of low - dose infusion of dopamine on serum concentrations of prolactin in critically ill patients. Methods Baseline serum was named as sample 1. After dopamine infusion for 8 h, serum sample 2 was obtained and dopamine infusion discontinued for another 8 h. After this time serum sample 3 was obtained. Serum prolactin concentrations of all samples were measured by an immulite prolactin chemiluminescent enzyme immunometric assay system. Results 64% of patients had a supernormal serum prolactin level. Eight hours after commencing the dopamine infusion, the average serum prolactin concentration decreased from 744. 96 to 124. 9 mU/L. This represented an average reduction of 83.2%, with 30% of patients exhibiting a subnormal concentration while receiving dopamine and this reduction was reversed after cessation of dopamine, with an increase of 82. 1%. Conclusions Prolactin secretion was increased in response to physiological stress, while a low - dose dopamine infusion in critically ill patients could markedly reduce serum concentrations of prolactin, which was associated with a reduction in the cellular immune response. This effect was reversible after cessation of dopamine.