高泌乳素血症166例分析

An analysis of 166 patients with hyperprolactinemia

目的探讨高泌乳素血症（HPRL）的临床表现、治疗方法及其与泌乳素腺瘤的关系。方法分析同济大学附属东方医院神经外科自2005年1月至2010年1月确诊为HPRL的166例患者临床资料、激素指标，其中4年为回顾性分析，1年为前瞻性研究。结果大部分患者的年龄分布在20-40岁，月经不调是最常见的临床表现，见于141例患者（84．9％）；其次是溢乳，见于114例患者（68．7％）。发病原因中，泌乳素微腺瘤见于62例患者（37.3％），无功能性垂体大腺瘤见于26例患者（15．7％）。泌乳素微腺瘤患者泌乳素水平为（161．2±60．6）ng／mL，和其他任一原因导致的HPRL患者泌乳素水平比较，差异均有统计学意义（P〈0．05）。结论泌乳素微腺瘤是HPRL最常见的病因，其次为特发性HPIU。单从血清泌乳素的水平并不能确定患者是否一定存在微腺瘤。

Objective To study the clinical manifestations and treatment methods of hyperprolactinemia （HPRL）, a common disorder encountered in clinical practice, and explore its association with prolactinomas. Methods The clinical data, hormone profile and imaging data of 166 females with documented HPRL, admitted to our hospital from January 2005 to January 2010, for over a period of 5 years, including 4 years of retrospective analysis and 1 year of prospective study, were retrospectively analyzed. Results Most patients aged 20-40 with abnormal menstruation as their most common symptom; 141 patients （84.9%） appeared abnormal menstruation and 114 （68.7%） with galactorrhea. Microadenoma was noted in 62 patients （37.3%）, nonfunctioning pituitary macroadenoma involved stalk occurred in 26 patients （15.7%）. As compared with that in patients with idiopathic HPRL （[93.9±20.4] ng/mL）, the level ofprolactin in patients with microprolactinoma （[161.2±60.6] ng/mL） was significantly higher （P〈0.05）; as compared with that in patients with prolactin microadenoma, the level of prolactin in patients with domperidone caused drag-induced HPRL （[240.2±29.4] ng/mL） was obviously increased （P〈0.05）. Conclusion We cannot confirm whether a HPRL patient has prolactinomas only through detecting the level ofprolactin. Microprolactinoma is the most common cause of HPRL, followed by idiopathic cause.