Size reduction of macroprolactinomas by bromocriptine or lisuride treatment.
Size reduction of macroprolactinomas by bromocriptine or lisuride treatment.
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通过溴隐亭或麦角乙脲治疗缩小催乳素大瘤的大小。
DOI：
10.1210/jcem-53-4-737
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发表时间：
1981
期刊：
影响因子：
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通讯作者：
Reinhard Horowski
中科院分区：
文献类型：
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作者：
P. Chiodini;Antonio Liuzzi;R. Cozzi;Giuseppe Verdexs;G. Oppizzi;D. Dallabonzana;B. Spelta;Franco Silvestrini;Giampaola Borghi;Giuseppe Luccarelli;Ernst Rainer;Reinhard Horowski
我们用多巴胺激动剂溴隐亭和利尿胺治疗29例巨大催乳素瘤患者1-50个月(平均+/-SE，12.7+/-1.8)，以评估这些药物对肿瘤大小的影响。14例患者服用溴隐亭(剂量范围为7.5~20 mg/d)，12例患者服用利尿胺(0.6~2 mg/d)，3例同时服用两种药物。治疗前和治疗期间进行的计算机断层扫描显示18例(62%)患者肿瘤缩小，但没有一例观察到肿瘤完全消失。在这些患者中，有5名患者甚至有可能在接受低剂量多巴胺激动剂治疗的第一个月内证明肿瘤缩小，而在其他患者中，肿瘤只有在长期接受高剂量治疗后才会缩小。在13例有视力缺陷的患者中，有8例的视野和视力有所改善或恢复正常；有些患者最早在治疗开始后2天就报告了这种改善。显示肿瘤大小缩小的所有患者的血浆PRL水平都下降了；在另外两名患者中，PRL水平仅被抑制得很差，肿瘤大小保持不变。在其余患者中，PRL水平降低，但没有令人信服的肿瘤缩小的证据。考虑到在药物治疗下肿瘤缩小的患者比例很高，我们建议使用多巴胺激动剂作为治疗巨大催乳素瘤患者的第一步，而不管患者是否存在视力障碍。
We have administered to 29 patients with macroprolactinoma the dopamine agonists bromocriptine and lisuride for 1-50 months (mean +/- SE, 12.7 +/- 1.8) in order to assess the effects of these drugs on tumor size. Fourteen patients were treated with bromocriptine (dose range, 7.5-20 mg/day), 12 patients were treated with lisuride (0.6-2 mg/day), and 3 patients were given both drugs. Computed tomography performed before and during treatment showed the occurrence of tumor shrinkage in 18 patients (62%), but in no case was a complete disappearance of the tumor observed. In 5 of these patients, it was even possible to document tumor shrinkage within the first month of treatment with low doses of the dopamine agonists, whereas in other patients, tumors shrank only after prolonged treatment with higher doses. Visual field and acuity improved or normalized in 8 of the 13 patients with visual defects; in some cases, the improvement was reported as early as 2 days after the treatment was started. Plasma PRL levels fell in all patients who showed a reduction in tumor size; in 2 other patients, PRL levels were only poorly suppressed, and tumor size remained unchanged. In the remaining patients, PRL levels were lowered without convincing evidence of tumor shrinkage. In considering the high percentage of patients showing tumor shrinkage under medical treatment, we propose a course with dopamine agonists as the first step in the management of patients with macroprolactinomas regardless of the presence of visual impairments.