泌乳素瘤多巴胺受体激动剂抵抗的机制与治疗进展

Mechanism and Therapy of Dopamine Receptor Agonist Resistance in Prolactinoma

泌乳素瘤是一种常见的内分泌垂体肿瘤,主要引发高泌乳素血症等内分泌症状及肿瘤压迫症状。多巴胺受体激动剂通常可有效的治疗泌乳素瘤。然而,部分患者采用多巴胺受体激动剂治疗后疗效不佳,产生药物抵抗。常用的多巴胺受体激动剂为溴隐亭及卡麦角林。溴隐亭总体耐药率为20%~30%,卡麦角林约为10%。目前主要是采用药物治疗、手术治疗及放射治疗的方法进行治疗耐药的泌乳素瘤,然而部分患者的病情仍未得到明显改善。本文对多巴胺受体激动剂抵抗的泌乳素瘤的发病机制、治疗方法及研究进展进行了综述,以便发现更有效的治疗手段。

Prolactinoma is a common endocrine pituitary tumor,which mainly causes hyperprolactinemia and tumor compression.Dopamine receptor agonists are effective in treating prolactinoma usually.However,some patients have poor prognosis after treatment with dopamine receptor agonists and show drug resistance.The dopamine receptor agonists which used commonly are bromocriptine and cabergoline.The overall rate of resistant to bromocriptine is 20%-30%compare to the resistant to cabergoline which is about 10%.At present,the treatments including drugs,surgery and radiotherapy are mainly used to treat drug-resistant prolactinoma,but the condition of patients have not been improved significantly.This article reviews the pathogenesis,treatments and research progress of prolactinoma that are ineffective to dopamine receptor agonist in order to find more effective treatments.