泌乳素瘤多巴胺受体激动剂治疗相关冲动控制障碍的诊疗进展

Progress of diagnosis and treatment for dopamine agonist-induced impulse control disorders in prolactinoma patients

泌乳素瘤是最常见的功能性垂体腺瘤,首选多巴胺受体激动剂作为一线治疗方案。在接受多巴胺受体激动剂治疗的泌乳素瘤患者中可能出现各种类型的冲动控制障碍(impulse control disorders,ICDs),如病理性赌博、强迫性购物、性欲亢进、强迫性进食等。这些不良反应会对患者的工作和生活造成严重的影响。然而目前国内缺少相关研究报道,内分泌学界对冲动控制障碍的临床表现、诊断及治疗缺乏全面的认识。本文就泌乳素瘤中ICDs的发生比例、发生机制、危险因素、诊断及治疗等方面展开综述,以深入了解泌乳素瘤多巴胺受体激动剂治疗相关ICDs,为今后在临床诊治中筛查识别及诊治提供帮助。

Prolactinoma is the most common functional pituitary adenoma,dopamine agonist(DA)is recommended as the first-line treatment for prolactinoma patients in clinical practice.Recently,impulse control disorders(ICDs)including pathological gambling,compulsive shopping,hypersexuality and compulsive eating have been reported in prolactinoma patients under the treatment of dopamine agonists.These abnormal behaviours might have serious impacts on both physical and mental health.However,endocrinologists lack a comprehensive understanding on the clinical features,diagnosis and treatment of ICDs.Few study of ICDs in prolactinoma has been reported in China.This review focuses on the prevalence,pathogenesis,risk factors,diagnosis and treatment of ICDs in prolactinoma patients were in order to provide guidance for future clinical practice.