顿服中等剂量溴隐亭对非急症性泌乳素型垂体腺瘤患者的疗效分析

Efficacy of moderate dose bromocriptine by one-off oral administration in patients with non-acute prolactin type pituitary adenoma

目的探讨顿服中等剂量溴隐亭对非急症性泌乳素(PRL)型垂体腺瘤患者的疗效。方法选择中国科学技术大学附属第一医院(安徽省立医院)神经外科自2016年1月至2017年12月收治的非急症性PRL型垂体腺瘤患者43例,分别在顿服溴隐亭5mg后2h、3h和12h检测血清PRL水平,通过PRL下降率判断患者的疗效,并比较不同性别、PRL初始值及不同年龄患者疗效的差异。结果43例患者顿服溴隐亭后有效20例,显效18例,无效5例。不同性别患者顿服溴隐亭后疗效的差异有统计学意义(P<0.05),女性患者的显效率明显高于男性患者;不同PRL初始值患者顿服溴隐亭后疗效的差异有统计学意义(P<0.05),PRL初始值为40~200ng/mL患者的显效率明显高于PRL初始值>200ng/mL患者;≤45岁患者和>45岁患者顿服溴隐亭后疗效的差异无统计学意义(P>0.05)。结论顿服中等剂量溴隐亭对女性、PRL初始值较低的非急症性PRL型垂体腺瘤患者疗效较好。

Objective To explore the efficacy of moderate dose bromocriptine by one-off oral administration in treatment of patients with non-acute prolactin (PRL) type pituitary adenoma. Methods Forty-three patients with definite diagnosis of non-acute prolactin type pituitary adenoma, admitted to our hospital from January 2016 to December 2017, were chosen in our study. All patients were administrated with 5 mg bromocriptine at 18 pm;the serum PRL levels were examined at 2, 3 and 12 h after bromocriptine administration. The curative effects of these patients were judged by decline rate of PRL, and the curative effects of patients with different genders, different initial PRL levels and different ages were compared. Results In these 43 patients, bromocriptine showed excellent effect in 20 patients, obvious effect in 18 and invalid effect in 5. There were statistically significant differences in the efficacy of bromocriptine between different genders (P<0.05). There were statistically significant differences in efficacy of patients with different genders after taking bromocriptine (P<0.05). The female patients had obviously higher rate of obvious effect than the male patients. Patients with different initial PRL values had statistically significant differences in efficacy after taking bromocriptine (P<0.05). Patients with PRL initial value of 40-200 ng/mL had significantly higher rate of obvious effect than patients with PRL initial value of >200 ng/mL. There was no significant difference in efficacy between patients≤45 years old and patients>45 years old (P>0.05). Conclusion The treatment of hyperprolactin caused by prolactin type pituitary adenoma with moderate dose bromocriptine by one-off oral administration is effective;female patients have obviously better effect than male patients;and for patients with initial prolactin>200 ng/mL, the effect is better.